SPECIALTY AND PRIMARY CARE LLC NPI 1174742720

NPI Information

  • NPI: 1174742720
  • Provider Name: SPECIALTY AND PRIMARY CARE LLC
  • Classification: Internal Medicine - 207RG0100X
  • Specialization: Gastroenterology
  • Entity Type: Organization
  • Address: 10004 KENNERLY RD
    257 A
    SAINT LOUIS, MO
    ZIP 63128
  • Phone: (314) 842-6333

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NPI Details

SPECIALTY AND 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 AND PRIMARY CARE LLC NPI is 1174742720. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

10004 KENNERLY RD
257 A
SAINT LOUIS, MO
ZIP 63128-141
Phone: (314) 842-6333
Fax: (314) 543-5271

The provider's authorized official is Zafar Quader .
The authorized official title is Medical Director and has the following contact phone number (314) 842-6333.

The enumeration date for this NPI number is 4/24/2007 and was last updated on 10/20/2015.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1208721902MEDICAIDMISSOURI
2205765MEDICARE PINILLINOIS
3DA8910OTHERMISSOURIRAILROAD MEDICARE
4361744184MEDICAIDILLINOIS
5000012699MEDICARE PINMISSOURI

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: 11/21/2025

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