| Wuca - Fenton Pediatrics, Llc | |
|
714 Gravois Rd Ste 200 Fenton MO 63026-7723 | |
| (636) 349-5437 | |
| (636) 349-6663 |
| Full Name | Wuca - Fenton Pediatrics, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 714 Gravois Rd Ste 200, Fenton, 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 |
|---|---|
| Wuca - Fenton Pediatrics, Llc 4240 Duncan Ave Ste 301 Saint Louis MO 63110-1123 Ph: () - | Wuca - Fenton Pediatrics, Llc 714 Gravois Rd Ste 200 Fenton MO 63026-7723 Ph: (636) 349-5437 |
| NPI Number | 1760953095 |
|---|---|
| Provider Enumeration Date | 12/16/2018 |
| Last Update Date | 10/02/2019 |
| Medicare PECOS PAC ID | 0840530481 |
|---|---|
| Medicare Enrollment ID | O20190319001480 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760953095 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Dawn M Roemer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093995466 PECOS PAC ID: 3274622246 Enrollment ID: I20071129000302 |
| Provider Name | Isabel Fernandez-holtzman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1629182852 PECOS PAC ID: 2163762626 Enrollment ID: I20190319002616 |
| Provider Name | Valerie R Kover |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1639348428 PECOS PAC ID: 9830439140 Enrollment ID: I20190325001180 |
| Provider Name | Diane M Eschmann Morie |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1902910292 PECOS PAC ID: 8426398686 Enrollment ID: I20190326000732 |
| Provider Name | Christine Vaughan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871966796 PECOS PAC ID: 9133531031 Enrollment ID: I20201217002484 |
| Provider Name | Lauren Jones |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1477084564 PECOS PAC ID: 2668744103 Enrollment ID: I20230901001719 |
Suburban West Internal Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1011 Bowles Ave, Suite 300, Fenton, MO 63026 Phone: 636-496-5000 Fax: 636-496-5045 | |
Rockwood Family Medicine Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1747 Smizer Station Rd, Suite 3b, Fenton, MO 63026 Phone: 636-529-9595 Fax: 636-529-9494 | |
Covington Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1747 Smizer Station Rd Ste 3a, Fenton, MO 63026 Phone: 636-225-8855 | |
Alegis Care - Missouri Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1400 S Highway Dr Ste 200, Fenton, MO 63026 Phone: 773-292-4800 | |
Physicians Health Group Medical Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 960 S. Highway Dr, Fenton, MO 63026 Phone: 636-305-2000 Fax: 314-584-7007 | |
Dr. Petre I Anguelinin, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1015 Bowles Ave, Fenton, MO 63026 Phone: 636-207-0277 | |
Family Practice Of South County Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1011 Bowles Ave, Suite 300, Fenton, MO 63026 Phone: 636-496-5000 Fax: 636-496-5055 |