MEDICARE: MCPHERSON MEDICAL & DIAGNOSTIC 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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1023871571
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MCPHERSON MEDICAL & DIAGNOSTIC LLC

Provider Business Mailing Address
First Line	:	216 W MAIN ST
Second Line	:
City	:	STEELE
State	:	MO
Zip	:	63877-1436
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2880 NETHERTON DR STE 200
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63136-4697
Country	:	US
Telephone Number	:	314-355-5300
Fax Number	:	314-521-4656

Authorized Official
Title or Position	:	OWNER
Name	:	ABDULLAH ARSHAD
Credential	:	MD
Telephone Number	:	573-724-0083

Provider Enumeration Date	:	02/06/2024
Last Update Date	:	02/06/2024

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