Medical West Podiatry LTD Medical West BLDG
Organization Active NPI Podiatrist · Clayton, MO
NPI 1790891075 · NPPES record last updated Dec 6, 2010
Key facts
- NPI
- 1790891075
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Podiatrist 213E00000X
- Legal business name
- MEDICAL WEST PODIATRY LTD MEDICAL WEST BLDG
- Practice address
- 950 Francis PL
Suite 2
Clayton, MO 63105-2465 - Phone
- (314) 726-2377
- Fax
- (314) 726-2397
- NPI assigned
- Aug 21, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Richard G Brandel, D.P.M.
- Title
- Podiatrist
- Phone
- (314) 726-2377
Practitioners 6
-
Neil A Ermitano, DPM
-
Syed Basar Rizvi, DPM
-
Jeffrey Robert Aschenbrenner, D.P.M.
-
Brandon Allen Doser, D.P.M.
-
Richard Glenn Brandel, D.P.M.
-
Colette S. Weber, D.P.M.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20101124000875 | MO | Part B Supplier - Clinic/Group Practice | 1557488517 |
Receives reassigned benefits from 4 practitioners Practice locations: Clayton, MO |
National Provider Directory
Locations
950 Francis Pl
Ste 2
Saint Louis, MO 63105
Phone (314) 726-2377
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist |
213E00000X | Yes |
Addresses
Primary practice location
950 Francis PL
Suite 2
Clayton, MO 63105-2465
Mailing address
950 Francis PL
Suite 2
Clayton, MO 63105-2465
Phone (314) 726-2377
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790891075 | Other | MO | DMERC |
Other providers in Clayton, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 6, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.