| Bodavula MD LLC | |
|
709 Turrentine Trl Creve Coeur MO 63141-6089 | |
| (914) 563-2943 | |
| Not Available |
| Full Name | Bodavula MD LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 709 Turrentine Trl, Creve Coeur, Missouri |
| Authorized Official Name and Position | Venkata KR Bodavula (SURGEON) |
| Authorized Official Contact | 9145632943 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bodavula MD LLC 709 Turrentine Trl Creve Coeur MO 63141-6089 Ph: (914) 563-2943 | Bodavula MD LLC 709 Turrentine Trl Creve Coeur MO 63141-6089 Ph: (914) 563-2943 |
| NPI Number | 1790183077 |
|---|---|
| Provider Enumeration Date | 12/18/2014 |
| Last Update Date | 12/18/2014 |
| Medicare PECOS PAC ID | 4587983697 |
|---|---|
| Medicare Enrollment ID | O20150512000091 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790183077 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 2010007564 (Missouri) | Primary |
| Provider Name | Venkata Krishna Rao Bodavula |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1275714784 PECOS PAC ID: 2961534334 Enrollment ID: I20100720001045 |
| Provider Name | Leah S. Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932557964 PECOS PAC ID: 8325332505 Enrollment ID: I20160810002800 |
Mid-town Medical Practice, LLC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 9 Sackston Woods Ln, Creve Coeur, MO 63141 Phone: 314-651-6132 |
Renewed Health 180 LP Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 456 N New Ballas Rd Ste 101a, Creve Coeur, MO 63141 Phone: 314-866-9940 |
Top Medical Center LP Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 456 N New Ballas Rd Ste 101, Creve Coeur, MO 63141 Phone: 314-384-3600 |
4ever-young Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11716 Studt Ave, Creve Coeur, MO 63141 Phone: 314-330-8117 |
Allies 4 Health LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 522 N New Ballas Rd Ste 245, Creve Coeur, MO 63141 Phone: 314-472-8333 |
Midwest Consulting and Ime Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 763 S New Ballas Rd, Suite 230, Creve Coeur, MO 63141 Phone: 314-681-2800 Fax: 314-432-5088 |