| Telegraph Road Family Practice | |
|
11110 Lindbergh Business Court St. Louis MO 63123-7810 | |
| (314) 845-8888 | |
| (314) 845-8833 |
| Full Name | Telegraph Road Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 11110 Lindbergh Business Court, St. Louis, Missouri |
| Authorized Official Name and Position | Daniel Joseph Meshoto (PHYSICIAN - CEO) |
| Authorized Official Contact | 3148458888 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Telegraph Road Family Practice 11110 Lindbergh Business Court St. Louis MO 63123-7810 Ph: (314) 845-8888 | Telegraph Road Family Practice 11110 Lindbergh Business Court St. Louis MO 63123-7810 Ph: (314) 845-8888 |
| NPI Number | 1699848150 |
|---|---|
| Provider Enumeration Date | 11/15/2006 |
| Last Update Date | 04/16/2015 |
| Medicare PECOS PAC ID | 4082748678 |
|---|---|
| Medicare Enrollment ID | O20100818000607 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699848150 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | DO104006 (Missouri) | Primary |
| Provider Name | Daniel Joseph Meshoto |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558334847 PECOS PAC ID: 5991839581 Enrollment ID: I20100818000627 |
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