| Slmg Long Term Group Llc | |
|
224 S Woods Mill Rd Ste 570 Chesterfield MO 63017-3513 | |
| (314) 205-6898 | |
| (314) 590-5911 |
| Full Name | Slmg Long Term Group Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 224 S Woods Mill Rd Ste 570, Chesterfield, Missouri |
| Authorized Official Name and Position | James Snider (VP PHYSICIAN NETWORK) |
| Authorized Official Contact | 6366857804 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Slmg Long Term Group Llc 232 S Woods Mill Rd Chesterfield MO 63017-3406 Ph: (636) 685-7804 | Slmg Long Term Group Llc 224 S Woods Mill Rd Ste 570 Chesterfield MO 63017-3513 Ph: (314) 205-6898 |
| NPI Number | 1265042535 |
|---|---|
| Provider Enumeration Date | 08/03/2020 |
| Last Update Date | 10/21/2020 |
| Medicare PECOS PAC ID | 6305266958 |
|---|---|
| Medicare Enrollment ID | O20201020001840 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265042535 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Sabiha Tabassum Siddiqui |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386669760 PECOS PAC ID: 0648280297 Enrollment ID: I20200416000862 |
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