| Desilva Medical Services Llc | |
|
6308 Hazelwest Ct Suite 200 Hazelwood MO 63042-1739 | |
| (314) 731-5555 | |
| (314) 731-5558 |
| Full Name | Desilva Medical Services Llc |
|---|---|
| Speciality | Internal Medicine - Adolescent Medicine |
| Location | 6308 Hazelwest Ct, Hazelwood, Missouri |
| Authorized Official Name and Position | Ananda Desilva (PHYSICIAN OWNER) |
| Authorized Official Contact | 3147315555 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Desilva Medical Services Llc 6308 Hazelwest Ct Suite 200 Hazelwood MO 63042-1739 Ph: (314) 731-5555 | Desilva Medical Services Llc 6308 Hazelwest Ct Suite 200 Hazelwood MO 63042-1739 Ph: (314) 731-5555 |
| NPI Number | 1184757072 |
|---|---|
| Provider Enumeration Date | 03/13/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184757072 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RA0000X | Internal Medicine - Adolescent Medicine | R9845 (Missouri) | Primary |
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