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NPI Code Detail

MEDICARE: MRS. ANNA D NAUMOVICH MD

MEDICARE: MRS. ANNA D NAUMOVICH MD
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
1207R00000XInternal Medicine Physician36914MO

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2110023391OTHERMORAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1669542668
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ANNA D NAUMOVICH MD
Provider Business Mailing Address
First Line : 5205 SOUTH GRAND AVE
Second Line :
City : ST LOUIS
State : MO
Zip : 63111
Country : US
Telephone Number : 314-481-7977
Fax Number : 314-481-4420
Provider Business Practice Location Address
First Line : 5205 SOUTH GRAND AVE
Second Line :
City : ST LOUIS
State : MO
Zip : 63111
Country : US
Telephone Number : 314-481-7977
Fax Number : 314-481-4420
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2006
Last Update Date : 03/27/2009

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