| Premier Healthcare Stl LLC | |
|
703 Hesemann Ridge Ct Ballwin MO 63021-3602 | |
| (636) 751-0362 | |
| Not Available |
| Full Name | Premier Healthcare Stl LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 703 Hesemann Ridge Ct, Ballwin, Missouri |
| Authorized Official Name and Position | Mohammad Amin Zaman (PRESIDENT) |
| Authorized Official Contact | 6367510362 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Healthcare Stl LLC 703 Hesemann Ridge Ct Wildwood MO 63021-3602 Ph: (636) 751-0362 | Premier Healthcare Stl LLC 703 Hesemann Ridge Ct Ballwin MO 63021-3602 Ph: (636) 751-0362 |
| NPI Number | 1053962357 |
|---|---|
| Provider Enumeration Date | 09/27/2019 |
| Last Update Date | 09/27/2019 |
| Medicare PECOS PAC ID | 2264864685 |
|---|---|
| Medicare Enrollment ID | O20191030001245 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053962357 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (NU) | Primary |
| Provider Name | Mohammad a Zaman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346350196 PECOS PAC ID: 6002701471 Enrollment ID: I20120120000457 |
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