| Dr Rebecca K Bullivant, MD | |
|
13001 N Outer 40 Rd, Ste 340, Chesterfield, MO 63017-5941 | |
| (314) 454-6444 | |
| (314) 454-6445 |
| Full Name | Dr Rebecca K Bullivant |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 13001 N Outer 40 Rd, Chesterfield, Missouri |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144217977 | NPI | - | NPPES |
| 200037980 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 100975 (Missouri) | Primary |
| Entity Name | Wuca-kids Docs Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1750741526 PECOS PAC ID: 8921388547 Enrollment ID: O20161216001114 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Rebecca K Bullivant, MD Po Box 7412121, Chicago, IL 60674-2121 Ph: (314) 454-6444 | Dr Rebecca K Bullivant, MD 13001 N Outer 40 Rd, Ste 340, Chesterfield, MO 63017-5941 Ph: (314) 454-6444 |
Dr. John Laurance Hoerr, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 226 S Woods Mill Rd Ste 32w, Chesterfield, MO 63017 Phone: 314-576-1616 | |
Dr. Katherine L Komendowski, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 226 S Woods Mill Rd, Ste 36w, Chesterfield, MO 63017 Phone: 314-453-9666 Fax: 314-453-9895 | |
Mohamad Al-hosni, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 14443 White Birch Valley Ln, Chesterfield, MO 63017 Phone: 314-629-5671 | |
Dr. Robert James Profumo, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1308 Westchester Manor Ln, Chesterfield, MO 63005 Phone: 314-432-9270 Fax: 314-432-9271 | |
Thomas Mckinney, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 226 S Woods Mill Rd Ste 32w, Chesterfield, MO 63017 Phone: 314-576-1616 Fax: 314-576-5271 | |
Bien Zhang, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 232 S Woods Mill Rd, Chesterfield, MO 63017 Phone: 314-542-4897 | |
Dr. Janet G Mueller, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 13001 N Outer 40 Rd, Ste 340, Chesterfield, MO 63017 Phone: 314-454-6444 Fax: 314-454-6445 |