| Mrs Erica Lynne Ibendahl, MD | |
|
One Hospital Drive, Mc 414 Mchaney Hall, Columbia, MO 65212 | |
| (573) 882-5609 | |
| (573) 884-4611 |
| Full Name | Mrs Erica Lynne Ibendahl |
|---|---|
| Gender | Female |
| Speciality | General Surgery |
| Experience | 13 Years |
| Location | One Hospital Drive, Columbia, Missouri |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134483514 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 2012017823 (Missouri) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Ssm Health St Mary's Hospital -centralia | Centralia, IL | Hospital |
| Ssm Health - Good Samaritan Hospital | Mount vernon, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Physician Services Corporation Of Southern Illinois Inc | 9234022567 | 103 |
| Entity Name | St Marys Hospital Centralia Illinois |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770687196 PECOS PAC ID: 6709788920 Enrollment ID: O20040127000118 |
| Entity Name | Physician Services Corporation Of Southern Illinois Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1831101807 PECOS PAC ID: 9234022567 Enrollment ID: O20040304000583 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Erica Lynne Ibendahl, MD One Hospital Drive, Mc 414 Mchaney Hall, Columbia, MO 65212 Ph: (573) 882-5609 | Mrs Erica Lynne Ibendahl, MD One Hospital Drive, Mc 414 Mchaney Hall, Columbia, MO 65212 Ph: (573) 882-5609 |
Olivia Louise Bolles, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 1 Hospital Dr, Columbia, MO 65212 Phone: 573-882-4141 | |
Ioan-andrei Scumpu, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 1 Hospital Dr, Mchaney Hall 404, Dco75.00, Columbia, MO 65212 Phone: 573-884-2000 | |
Marc L Miller, DO Surgery Medicare: Accepting Medicare Assignments Practice Location: 115 Business Loop 70 W, Columbia, MO 65203 Phone: 573-882-8454 Fax: 573-884-6054 | |
Dr. Mary Carr, MD Surgery Medicare: Medicare Enrolled Practice Location: 800 Hospital Dr, Columbia, MO 65201 Phone: 573-814-6000 | |
Brent W Miedema, MD Surgery Medicare: Medicare Enrolled Practice Location: 800 Hospital Dr # 617, Columbia, MO 65201 Phone: 573-814-6346 | |
Dr. Kelley Marie Ray, MD Surgery Medicare: Medicare Enrolled Practice Location: 1 Hospital Dr, Columbia, MO 65212 Phone: 573-884-2000 | |
Thalia Catalina Anderson, MD Surgery Medicare: Medicare Enrolled Practice Location: 1 Hospital Dr, Columbia, MO 65212 Phone: 573-882-4141 |