| Blue Medical Llc | |
|
1029 W Battlefield St Apt E312 Springfield MO 65807-4384 | |
| (417) 444-3501 | |
| Not Available |
| Full Name | Blue Medical Llc |
|---|---|
| Speciality | General Practice |
| Location | 1029 W Battlefield St Apt E312, Springfield, Missouri |
| Authorized Official Name and Position | Brian Maurice Shefulsky (OWNER) |
| Authorized Official Contact | 4174443501 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Medical Llc 4319 S National Ave # 309 Springfield MO 65810-2607 Ph: (417) 444-3501 | Blue Medical Llc 1029 W Battlefield St Apt E312 Springfield MO 65807-4384 Ph: (417) 444-3501 |
| NPI Number | 1124818729 |
|---|---|
| Provider Enumeration Date | 05/08/2025 |
| Last Update Date | 05/08/2025 |
| Medicare PECOS PAC ID | 4284143447 |
|---|---|
| Medicare Enrollment ID | O20250530002341 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124818729 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Brian M Shefulsky |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1992189997 PECOS PAC ID: 1052732005 Enrollment ID: I20200601000443 |
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