| Tallam Inpatient Medicine Pc | |
|
3015 N Ballas Rd Saint Louis MO 63131-2329 | |
| (314) 996-5000 | |
| (636) 333-4510 |
| Full Name | Tallam Inpatient Medicine Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3015 N Ballas Rd, Saint Louis, Missouri |
| Authorized Official Name and Position | Rama Tallam (OWNER) |
| Authorized Official Contact | 6363334500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tallam Inpatient Medicine Pc Po Box 7355 Chesterfield MO 63006-7355 Ph: (314) 996-5000 | Tallam Inpatient Medicine Pc 3015 N Ballas Rd Saint Louis MO 63131-2329 Ph: (314) 996-5000 |
| NPI Number | 1972549475 |
|---|---|
| Provider Enumeration Date | 06/22/2006 |
| Last Update Date | 07/24/2024 |
| Medicare PECOS PAC ID | 9032171103 |
|---|---|
| Medicare Enrollment ID | O20041101000553 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972549475 | NPI | - | NPPES |
| 507418002 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Rama Tallam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174569537 PECOS PAC ID: 7416919824 Enrollment ID: I20041028000579 |
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