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CHESTERFIELD MEDCENTER LLC NPI 1063448066


NPI Information

NPI: 1063448066
Provider Name: CHESTERFIELD MEDCENTER LLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 26D0878773

Address:
1751 CLARKSON RD
CHESTERFIELD, MO
ZIP 63017
Phone: (636) 537-0377
Get Directions

CHESTERFIELD MEDCENTER LLC is a family medicine in Chesterfield, MO. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. CHESTERFIELD MEDCENTER LLC NPI is 1063448066. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1751 CLARKSON RD
CHESTERFIELD, MO
ZIP 63017
Phone: (636) 537-0377
Fax: (636) 537-2655

The provider's authorized official is Vladimir Gelfand .
The authorized official title is Physician Owner and has the following contact phone number (636) 537-0377.

The CLIA number assigned to this NPI record is 26D0878773 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/23/2006 and was last updated on 7/21/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1505033506MEDICAIDMISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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