| St Louis Medical Professionals, Llc | |
|
8790 Watson Rd Suite 201 Saint Louis MO 63119-5140 | |
| (314) 543-2800 | |
| (314) 543-2801 |
| Full Name | St Louis Medical Professionals, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 8790 Watson Rd, Saint Louis, Missouri |
| Authorized Official Name and Position | Neeveen Salama (BILLING) |
| Authorized Official Contact | 3145432800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St Louis Medical Professionals, Llc 8790 Watson Rd Suite 201 Saint Louis MO 63119-5140 Ph: (314) 543-2800 | St Louis Medical Professionals, Llc 8790 Watson Rd Suite 201 Saint Louis MO 63119-5140 Ph: (314) 543-2800 |
| NPI Number | 1396826152 |
|---|---|
| Provider Enumeration Date | 10/18/2006 |
| Last Update Date | 06/26/2024 |
| Medicare PECOS PAC ID | 7012937253 |
|---|---|
| Medicare Enrollment ID | O20051201000971 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396826152 | NPI | - | NPPES |
| 507345502 | Medicaid | MO | |
| 133658 | Other | MO | BLUE CROSS BLUE SHIELD |
| CJ3494 | Other | MO | MEIDCARE RAILROAD |
| 62328300001 | Other | MO | DMEPTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Secondary |
| Provider Name | Max H David |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1629159413 PECOS PAC ID: 1951290444 Enrollment ID: I20040312000672 |
| Provider Name | Phu Thanh Tran |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427095132 PECOS PAC ID: 3072562362 Enrollment ID: I20050113000337 |
| Provider Name | James R Mcadam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578599254 PECOS PAC ID: 1052338613 Enrollment ID: I20051102000285 |
| Provider Name | Hany S Salama |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619064656 PECOS PAC ID: 4587763404 Enrollment ID: I20071204000856 |
| Provider Name | Ahmed S Ali |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1194887265 PECOS PAC ID: 4880783885 Enrollment ID: I20090812000493 |
| Provider Name | Saad Alkaade |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033433594 PECOS PAC ID: 9436283652 Enrollment ID: I20100810000548 |
| Provider Name | Erin E Kern |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407180441 PECOS PAC ID: 6608032958 Enrollment ID: I20120731000860 |
| Provider Name | Megan N Fjellanger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881014249 PECOS PAC ID: 0840413415 Enrollment ID: I20140529000660 |
| Provider Name | Braden F Deloach |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619231248 PECOS PAC ID: 9032336078 Enrollment ID: I20140814001394 |
| Provider Name | James York |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578827101 PECOS PAC ID: 0446479430 Enrollment ID: I20140924002423 |
| Provider Name | Denise Flynn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063956910 PECOS PAC ID: 1951685189 Enrollment ID: I20170307000437 |
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