Provider Demographics
NPI:1437328572
Name:EXCEL CARE ORTHOPEDICS, INC.
Entity Type:Organization
Organization Name:EXCEL CARE ORTHOPEDICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAFAT
Authorized Official - Middle Name:S
Authorized Official - Last Name:NASHED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-355-6070
Mailing Address - Street 1:1836 LACKLAND HILL PKWY
Mailing Address - Street 2:ATTN: CREDENTIALING DEPARTMENT
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-3572
Mailing Address - Country:US
Mailing Address - Phone:314-872-1439
Mailing Address - Fax:314-810-1399
Practice Address - Street 1:2865 NETHERTON DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63136-4674
Practice Address - Country:US
Practice Address - Phone:314-355-6070
Practice Address - Fax:314-355-5716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-22
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO104163207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DN9731Medicare PIN
MO6172410001Medicare NSC
MOMA1183Medicare PIN
IL216898Medicare PIN