Organization
SPECIALTY AND PRIMARY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ZAFAR QUADER MD (MEDICAL DIRECTOR)
(314) 842-6333
Entity
Organization
Contact information
Practice address
10004 KENNERLY RD, 257 A, SAINT LOUIS, MO 63128-2141
(314) 842-6333
(314) 543-5271
Mailing address
10004 KENNERLY RD, 257 A, SAINT LOUIS, MO 63128-2141
(314) 842-6333
(314) 543-5271
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
109425
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208721902
—
MO
05
—
361744184
—
IL
01
—
DA8910
RAILROAD MEDICARE
MO
Enumeration date
04/24/2007
Last updated
10/20/2015
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