MEDICARE: AMEDI DIABETOLOGY CONSULTING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QB0505X	Diabetology Physician

General Provider Information

NPI Number	:	1366306425
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMEDI DIABETOLOGY CONSULTING LLC

Provider Business Mailing Address
First Line	:	117 S LEXINGTON ST STE 100
Second Line	:
City	:	HARRISONVILLE
State	:	MO
Zip	:	64701-2443
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3394 MCKELVEY RD STE 102
Second Line	:
City	:	BRIDGETON
State	:	MO
Zip	:	63044-2531
Country	:	US
Telephone Number	:	314-325-2539
Fax Number	:	205-793-7382

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	DR. KAHEE MOHAMMED
Credential	:	MD
Telephone Number	:	314-489-5980

Provider Enumeration Date	:	12/12/2025
Last Update Date	:	12/12/2025

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