| West County Infectious Disease, Llc | |
|
10004 Kennerly Rd Ste 392 Saint Louis MO 63128-2141 | |
| (636) 489-1602 | |
| (636) 600-5294 |
| Full Name | West County Infectious Disease, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 10004 Kennerly Rd Ste 392, Saint Louis, Missouri |
| Authorized Official Name and Position | Polly K David (OWNER) |
| Authorized Official Contact | 3144779827 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| West County Infectious Disease, Llc 16918 Westridge Oaks Dr Grover MO 63040-1127 Ph: (636) 566-8155 | West County Infectious Disease, Llc 10004 Kennerly Rd Ste 392 Saint Louis MO 63128-2141 Ph: (636) 489-1602 |
| NPI Number | 1194125195 |
|---|---|
| Provider Enumeration Date | 08/26/2014 |
| Last Update Date | 01/06/2023 |
| Medicare PECOS PAC ID | 7315166451 |
|---|---|
| Medicare Enrollment ID | O20141020002426 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194125195 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (Missouri) | Primary |
| Provider Name | Max H David |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1629159413 PECOS PAC ID: 1951290444 Enrollment ID: I20040312000672 |
| Provider Name | Francisco M Pherez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386881902 PECOS PAC ID: 8123179819 Enrollment ID: I20090618000702 |
| Provider Name | Polly Kate David |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1649501834 PECOS PAC ID: 2668503004 Enrollment ID: I20100628001042 |
| Provider Name | Qian Wang |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1477904662 PECOS PAC ID: 3577855980 Enrollment ID: I20210603001644 |
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