| Walter G Holloman Jr, MD | |
|
3015 N New Ballas Rd, St Louis, MO 63131 | |
| (314) 996-5180 | |
| (314) 821-2180 |
| Full Name | Walter G Holloman Jr |
|---|---|
| Gender | Male |
| Speciality | Radiology - Diagnostic Radiology |
| Location | 3015 N New Ballas Rd, St Louis, Missouri |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942383914 | NPI | - | NPPES |
| 135370 | Other | H LINK | |
| A12402 | Other | GATE WAY | |
| 002013128 | Other | CARE | |
| 1600226 | Other | PH PLAN | |
| 6167 | Other | MCARE USA | |
| 2781 | Other | GHP | |
| 27600 | Other | BLUE CHOICE | |
| 300066998 | Other | RR CARE | |
| 017012444 | Other | MO CARE | |
| 04802710571 | Other | IL CAID | |
| 201047818 | Other | MO CAID | |
| 201047818 | Other | MC MCAID | |
| 431725842MID | Other | MERCY | |
| 002013128 | Other | MO CARE | |
| 017012444 | Other | CARE | |
| 398023 | Other | HLT PART | |
| 0090000352 | Other | IL BLUE | |
| 1390 | Other | MO BLUE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | R6596 (Missouri) | Primary |
| 2085R0202X | Radiology - Diagnostic Radiology | 036061640 (Illinois) | Secondary |
| Mailing Address | Practice Location Address |
|---|---|
| Walter G Holloman Jr, MD 55 Westport Plz, Suite 300, Saint Louis, MO 63146-3109 Ph: (314) 548-4772 | Walter G Holloman Jr, MD 3015 N New Ballas Rd, St Louis, MO 63131 Ph: (314) 996-5180 |
John A Merkle, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 774 N New Ballas Rd, St Louis, MO 63141 Phone: 314-567-1656 Fax: 314-567-0622 | |
Humberto M Fagundes, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 3015 N New Ballas Rd, St Louis, MO 63131 Phone: 314-996-5180 Fax: 314-821-2180 | |
Bruce J Walz, MD Radiology Medicare: Medicare Enrolled Practice Location: 3635 Vista, St Louis, MO 63110 Phone: 314-577-8815 Fax: 314-268-5106 | |
Jenny Lynne Shaffer, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 10010 Kennerly Road, Attn Cancer Care Center, St Louis, MO 63128 Phone: 314-525-1688 Fax: 314-525-1689 | |
John H Niemeyer, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 3015 N New Ballas Rd, St Louis, MO 63131 Phone: 314-996-5180 Fax: 314-821-2180 | |
Ustun Aydingoz, MD Radiology Medicare: Medicare Enrolled Practice Location: 3635 Vista, St Louis, MO 63110 Phone: 314-268-5783 Fax: 314-268-5116 | |
Amy A Mosher, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 3015 N New Ballas Rd, St Louis, MO 63131 Phone: 314-966-5180 Fax: 314-821-2180 |