| Edelmed LLC | |
|
12371 Mulberry Tree Ct Creve Coeur MO 63141-5470 | |
| (636) 942-2223 | |
| (636) 942-2223 |
| Full Name | Edelmed LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 12371 Mulberry Tree Ct, Creve Coeur, Missouri |
| Authorized Official Name and Position | Adam J Edelman (OWNER) |
| Authorized Official Contact | 3146147794 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Edelmed LLC 12371 Mulberry Tree Ct Creve Coeur MO 63141-5470 Ph: (636) 942-2223 | Edelmed LLC 12371 Mulberry Tree Ct Creve Coeur MO 63141-5470 Ph: (636) 942-2223 |
| NPI Number | 1467784843 |
|---|---|
| Provider Enumeration Date | 02/09/2010 |
| Last Update Date | 02/09/2010 |
| Medicare PECOS PAC ID | 9830228121 |
|---|---|
| Medicare Enrollment ID | O20100525000592 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467784843 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 2003027198 (Missouri) | Primary |
| Provider Name | Adam J Edelman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649384090 PECOS PAC ID: 5597866145 Enrollment ID: I20070726000096 |
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