MEDICARE: NETCARE HEALTH PROFESSIONALS, INC.

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	208M00000X	Hospitalist Physician	MD201504	LA

General Provider Information

NPI Number	:	1518111368
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NETCARE HEALTH PROFESSIONALS, INC.

Provider Business Mailing Address
First Line	:	10805 SUNSET OFFICE DR
Second Line	:	SUITE 300
City	:	SAINT LOUIS
State	:	MO
Zip	:	63127-1017
Country	:	US
Telephone Number	:	314-995-6262
Fax Number	:	314-995-6260

Provider Business Practice Location Address
First Line	:	10805 SUNSET OFFICE DR
Second Line	:	SUITE 300
City	:	SAINT LOUIS
State	:	MO
Zip	:	63127-1017
Country	:	US
Telephone Number	:	314-995-6262
Fax Number	:	314-995-6260

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	HABTOM HAILEMARIAM
Credential	:
Telephone Number	:	314-995-6262

Provider Enumeration Date	:	11/06/2008
Last Update Date	:	11/06/2008

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