1609092246 NPI number — H K INTERNAL MEDICINE ASSOCIATES L.L.C.

Table of content: (NPI 1609092246)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609092246 NPI number — H K INTERNAL MEDICINE ASSOCIATES L.L.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
H K INTERNAL MEDICINE ASSOCIATES L.L.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1609092246
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/16/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 771916
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAINT LOUIS
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63177-1916
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
314-878-0163
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13190 S OUTER 40
Provider Second Line Business Practice Location Address:
MEADOW VIEW BUILDING LEVEL 1
Provider Business Practice Location Address City Name:
CHESTERFIELD
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63017-5917
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-392-6380
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/18/2007

Additional Information

Authorized Official

Authorized Official Last Name:
EKRAMUDDIN
Authorized Official First Name:
HELAL
Authorized Official Middle Name:
Authorized Official Title or Position:
DOCTOR
Authorized Official Telephone Number:
314-355-2700

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 502859200 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".




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