| Integrated Medical Group, LLC | |
|
6155 S Grand Blvd Ste 140 Saint Louis MO 63111-2319 | |
| (314) 526-6093 | |
| Not Available |
| Full Name | Integrated Medical Group, LLC |
|---|---|
| Speciality | General Practice |
| Location | 6155 S Grand Blvd Ste 140, Saint Louis, Missouri |
| Authorized Official Name and Position | Mitchell Liberman (MANAGER) |
| Authorized Official Contact | 3143743408 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrated Medical Group, LLC 6155 S Grand Blvd Ste 140 Saint Louis MO 63111-2319 Ph: (314) 526-6093 | Integrated Medical Group, LLC 6155 S Grand Blvd Ste 140 Saint Louis MO 63111-2319 Ph: (314) 526-6093 |
| NPI Number | 1265327076 |
|---|---|
| Provider Enumeration Date | 06/11/2025 |
| Last Update Date | 06/11/2025 |
| Certification Date | 06/11/2025 |
| Medicare PECOS PAC ID | 8729592365 |
|---|---|
| Medicare Enrollment ID | O20250708000218 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265327076 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | () | Primary |
| Provider Name | Mitchell a Liberman |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1669695540 PECOS PAC ID: 1951465269 Enrollment ID: I20190410002092 |
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