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SPECIALTY & PRIMARY CARE LLC NPI 1104954692


NPI Information

NPI: 1104954692
Provider Name: SPECIALTY & PRIMARY CARE LLC
Classification: Internal Medicine - 207RG0100X
Entity Type: Organization

Specialization: Gastroenterology

Address:
3009 N BALLAS RD
SUITE 229A
SAINT LOUIS, MO
ZIP 63131
Phone: (314) 432-5144
Get Directions

SPECIALTY & PRIMARY CARE LLC is a gastroenterology internal medicine in Saint Louis, MO. The provider is an internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. SPECIALTY & PRIMARY CARE LLC NPI is 1104954692. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

3009 N BALLAS RD
SUITE 229A
SAINT LOUIS, MO
ZIP 63131-322
Phone: (314) 432-5144
Fax: (314) 432-2400

The provider's authorized official is Nayyer Ibrahim .
The authorized official title is Administrator and has the following contact phone number (314) 432-5144.

The enumeration date for this NPI number is 2/28/2007 and was last updated on 3/17/2009.


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
1207RG0100XInternal MedicineGastroenterology109425MISSOURIYes

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
1G18528MEDICARE UPINMISSOURI
2208721902MEDICAIDMISSOURI
3000012699MEDICARE ID-TYPE UNSPECIFIEDMISSOURI
4205765MEDICARE PINILLINOIS
5361744184MEDICAIDILLINOIS

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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