| Rtk Geromed Consultant | |
|
3760 S Lindbergh Blvd Suite 101 Saint Louis MO 63127-1358 | |
| (636) 634-5865 | |
| (314) 849-5716 |
| Full Name | Rtk Geromed Consultant |
|---|---|
| Speciality | Internal Medicine |
| Location | 3760 S Lindbergh Blvd, Saint Louis, Missouri |
| Authorized Official Name and Position | Rafi T Kevorkian (PRESIDENT) |
| Authorized Official Contact | 6366345865 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rtk Geromed Consultant 3760 S Lindbergh Blvd Suite 101 Saint Louis MO 63127-1358 Ph: (636) 634-5865 | Rtk Geromed Consultant 3760 S Lindbergh Blvd Suite 101 Saint Louis MO 63127-1358 Ph: (636) 634-5865 |
| NPI Number | 1245475482 |
|---|---|
| Provider Enumeration Date | 12/02/2008 |
| Last Update Date | 12/09/2008 |
| Medicare PECOS PAC ID | 5294898904 |
|---|---|
| Medicare Enrollment ID | O20090122000364 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245475482 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | 108134 (Missouri) | Primary |
| Provider Name | Rafi Kevorkian |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1124073630 PECOS PAC ID: 3274433560 Enrollment ID: I20040112000343 |
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