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General NPI Number Information
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NPI Number | 1518111368
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Entity Type | Organization
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Legal Business Name | NETCARE HEALTH PROFESSIONALS, INC.
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Dates
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Enumeration Date | 11/06/2008
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Last Update Date | 11/06/2008
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Provider Practice Location Address
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Address Line | 10805 SUNSET OFFICE DR SUITE 300
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City | SAINT LOUIS
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State | MO
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Zip | 63127-1017
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Country | US
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Telephone | 314-995-6262
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Fax | 314-995-6260
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Provider Business Mailing Address
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Address Line | 10805 SUNSET OFFICE DR SUITE 300
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City | SAINT LOUIS
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State | MO
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Zip | 63127-1017
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Country | US
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Telephone | 314-995-6262
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Fax | 314-995-6260
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | HABTOM HAILEMARIAM
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Credential |
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Telephone | 314-995-6262
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | MD201504
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License Number State | LA
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