| Irim A Massay, MD | |
| 
					300 1st Capitol Dr, Saint Charles, MO 63301-2844  | |
| (314) 317-0600 | |
| (314) 317-0606 | 
| Full Name | Irim A Massay | 
|---|---|
| Gender | Female | 
| Speciality | Internal Medicine | 
| Location | 300 1st Capitol Dr, Saint Charles, Missouri | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1619931110 | NPI | - | NPPES | 
| 1619931110 | Medicaid | MO | |
| 1619931110 | Medicaid | IL | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 208M00000X | Hospitalist | 2008017169 (Missouri) | Secondary | 
| 207R00000X | Internal Medicine | 2008017169 (Missouri) | Primary | 
| Entity Name | Southeastern Physician Services Pc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1083835441 PECOS PAC ID: 0042307852 Enrollment ID: O20160809000235  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Irim A Massay, MD 12101 Woodcrest Executive Dr, Suite 210, Saint Louis, MO 63141-5047 Ph: (314) 317-0600  | Irim A Massay, MD 300 1st Capitol Dr, Saint Charles, MO 63301-2844 Ph: (314) 317-0600  | 
Lawrence Stephen Tierney, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 400 1st Capitol Dr Ste 201, Saint Charles, MO 63301 Phone: 636-669-2332  | |
Syed A Khalid, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 300 1st Capitol Dr, Saint Charles, MO 63301 Phone: 636-647-5000 Fax: 636-947-5090  | |
Guangchen Zou, M.D. Internal Medicine Medicare: Medicare Enrolled Practice Location: 1820 Zumbehl Rd Ste 120, Saint Charles, MO 63303 Phone: 314-801-5350 Fax: 314-801-5323  | |
Dr. Stephen M Comens, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 1551 Wall St, 4th Floor, Saint Charles, MO 63303 Phone: 636-669-2220 Fax: 636-669-2401  | |
Dr. Shephali Himanshu Wulff, D.O Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 330 1st Capitol Dr Ste 260, Saint Charles, MO 63301 Phone: 636-925-0900  | |
Keith Wickenhauser, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 711 Veterans Memorial Pkwy Ste 300, Saint Charles, MO 63303 Phone: 636-669-2350  | |
Jerome E Thurman, M.D.,F.A.C.E. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 711 Veterans Memorial Pkwy Ste 200, Saint Charles, MO 63303 Phone: 636-669-2219 Fax: 636-669-2380  |