Celso Ferreira Rodrigues, M.D.

Individual provider Active NPI Internal Medicine Physician · Imperial, MO

NPI 1861403628 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1861403628
Entity type
Individual (NPI type 1)
Primary specialty
Internal Medicine Physician 207R00000X
License
2001012442 (MO)
Practice address
2674 Fox Run Dr
Imperial, MO 63052-2024
Phone
(636) 461-2711
NPI assigned
Aug 10, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2001012442MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Forest Park Emergency Physicians LLC Past Accepting new patients
Generations Family Medicine PC Past Accepting new patients
Cardiology Consultants LTD Internal Medicine Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2001012442 MO Yes

Addresses

Primary practice location

2674 Fox Run Dr
Imperial, MO 63052-2024

Mailing address

2674 Fox Run Dr
Imperial, MO 63052-2024
Phone (636) 461-2711

Other providers in Imperial, MO

All providers in Imperial, MO · Internal Medicine Physician in Missouri

Sources for this page

Verify at the official NPI Registry.