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NPI Code Detail

MEDICARE: ELDAD SHAUL BIALECKI M.D.

MEDICARE: ELDAD SHAUL BIALECKI M.D.
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
1207RG0100XGastroenterology Physician2003013331MO

General Provider Information

NPI Number : 1003952458
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELDAD SHAUL BIALECKI M.D.
Provider Business Mailing Address
First Line : PO BOX 959354
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63195-9354
Country : US
Telephone Number : 636-344-1073
Fax Number : 636-344-1075
Provider Business Practice Location Address
First Line : 20 PROGRESS POINT PKWY STE 206
Second Line :
City : O FALLON
State : MO
Zip : 63368-2207
Country : US
Telephone Number : 636-344-1073
Fax Number : 636-344-1075
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2007
Last Update Date : 03/17/2026

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