| Motog Inc. | |
|
3394 Mckelvey Rd Ste 115 Bridgeton MO 63044-2531 | |
| (314) 866-7116 | |
| (314) 380-0872 |
| Full Name | Motog Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 3394 Mckelvey Rd Ste 115, Bridgeton, Missouri |
| Authorized Official Name and Position | Ernesto Gutierrez (OWNER/PRESIDENT) |
| Authorized Official Contact | 3148667116 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Motog Inc. 3394 Mckelvey Rd Ste 115 Bridgeton MO 63044-2531 Ph: (314) 866-7116 | Motog Inc. 3394 Mckelvey Rd Ste 115 Bridgeton MO 63044-2531 Ph: (314) 866-7116 |
| NPI Number | 1750564647 |
|---|---|
| Provider Enumeration Date | 12/13/2007 |
| Last Update Date | 08/22/2025 |
| Medicare PECOS PAC ID | 3072564053 |
|---|---|
| Medicare Enrollment ID | O20050208000073 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750564647 | NPI | - | NPPES |
| CO1315 | Other | MO | MEDICARE RR |
| 2107378-003 | Other | MO | CIGNA |
| 100529 | Other | MO | BCBS |
| 617V4439 | Other | MO | CMR |
| D04076 | Other | MO | EXCLUSIVE CHOICCE |
| 00001383 | Other | MO | NHC HEALTH BENEFITS |
| 2161557 | Other | MO | AETNA |
| 830062299 | Medicaid | MO | |
| 100380 | Other | MO | HEALTHLINK |
| 0400423 | Other | MO | UHC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 35000 (Missouri) | Primary |
| Provider Name | Ernesto Gutierrez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831191725 PECOS PAC ID: 8123101318 Enrollment ID: I20101007000270 |
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