| Washington University | |
|
4921 Parkview Pl Ste 5a Saint Louis MO 63110-1032 | |
| (314) 747-5900 | |
| (314) 747-5936 |
| Full Name | Washington University |
|---|---|
| Speciality | Clinic/Center |
| Location | 4921 Parkview Pl Ste 5a, Saint Louis, Missouri |
| Authorized Official Name and Position | Cathy Eghigian (DIRECTOR, CREDENTIALING OPERATIONS) |
| Authorized Official Contact | 3142730770 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Washington University 4240 Duncan Ave Ste 301 Saint Louis MO 63110-1123 Ph: (314) 273-0770 | Washington University 4921 Parkview Pl Ste 5a Saint Louis MO 63110-1032 Ph: (314) 747-5900 |
| NPI Number | 1013542877 |
|---|---|
| Provider Enumeration Date | 03/11/2020 |
| Last Update Date | 03/11/2020 |
| Medicare PECOS PAC ID | 9830008770 |
|---|---|
| Medicare Enrollment ID | O20200520002289 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013542877 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Myra L Rubio |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023031044 PECOS PAC ID: 0648394684 Enrollment ID: I20100827000869 |
| Provider Name | Matthew J Bonzelet |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861626574 PECOS PAC ID: 0840440004 Enrollment ID: I20121024000262 |
| Provider Name | Elizabeth Segura |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477028520 PECOS PAC ID: 4880948843 Enrollment ID: I20181112000838 |
| Provider Name | Amanda Parrett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417459694 PECOS PAC ID: 5395008742 Enrollment ID: I20201202002766 |
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