Provider Demographics
NPI:1568590750
Name:INTERNAL MEDICINE ASSOCIATES, LTD.
Entity Type:Organization
Organization Name:INTERNAL MEDICINE ASSOCIATES, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:K
Authorized Official - Last Name:KAEMMERLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-887-6260
Mailing Address - Street 1:224 S WOODS MILL RD
Mailing Address - Street 2:SUITE 500 SOUTH
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-3451
Mailing Address - Country:US
Mailing Address - Phone:314-878-6260
Mailing Address - Fax:314-878-8058
Practice Address - Street 1:224 S WOODS MILL RD
Practice Address - Street 2:SUITE 500 SOUTH
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-3451
Practice Address - Country:US
Practice Address - Phone:314-878-6260
Practice Address - Fax:314-878-8058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO100880207R00000X
MOR4781207RA0201X, 207RP1001X
MO115477207RA0201X
MO34594207RG0100X
MOR8J79207RR0500X
MOR1K56207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & ImmunologyGroup - Multi-Specialty
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO990000038Medicare ID - Type UnspecifiedGROUP ID