Healthcare Provider Details

I. General information

NPI: 1366306425
Provider Name (Legal Business Name): AMEDI DIABETOLOGY CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3394 MCKELVEY RD STE 102
BRIDGETON MO
63044-2531
US

IV. Provider business mailing address

117 S LEXINGTON ST STE 100
HARRISONVILLE MO
64701-2443
US

V. Phone/Fax

Practice location:
  • Phone: 314-325-2539
  • Fax: 205-793-7382
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QB0505X
TaxonomyDiabetology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KAHEE MOHAMMED
Title or Position: MANAGING MEMBER
Credential: MD
Phone: 314-489-5980