DR. SAM G. BISHARA (NPI# 1194949784) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194949784 |
| Entity Type | Individual |
| Full Name | DR. SAM G. BISHARA |
| Credential | M.D. |
| Practice Address |
11125 Dunn Rd Suite 204 Saint Louis MO 63136-6132 |
| Practice Telephone | 3148395522 |
| Practice Fax Number | 3148395351 |
| Mailing Telephone | 3148395522 |
| Mailing Fax Number | 3148395351 |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2016-02-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
2009031839 | MO | Allopathic & Osteopathic Physicians |
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
2009031839 | MO | Allopathic & Osteopathic Physicians |
| Street Address |
11125 DUNN RD SUITE 204 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63136-6132 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083617294 | Morin Michael Hanson | Surgery | 11125 Dunn Rd, Ste 402, Saint Louis, MO 63136-6132 | 2005-05-23 |
| 1033612502 | Casey Wikiera | Counselor | 11125 Dunn Rd, Saint Louis, MO 63136-6132 | 2018-03-12 |
| 1457707705 | Renee Mcdonald | Nurse Practitioner | 11125 Dunn Rd, Suite 204, Saint Louis, MO 63136-6132 | 2016-05-05 |
| 1518320001 | Emily Rutledge | Case Manager/Care Coordinator | 11125 Dunn Rd, Suite 201, Saint Louis, MO 63136-6132 | 2016-04-01 |
| 1881060812 | Victoria Fisher | Counselor | 11125 Dunn Rd, Saint Louis, MO 63136-6132 | 2015-08-13 |
| 1942676101 | Nicole Willmering | Community Health Worker | 11125 Dunn Rd, Saint Louis, MO 63136-6132 | 2015-08-11 |
| 1457746125 | Claudia Bledsoe | Case Manager/Care Coordinator | 11125 Dunn Rd, Professional Bulding #2 Suite 201, Saint Louis, MO 63136-6132 | 2015-03-31 |
| 1295146744 | Carnecia Cole | Pharmacist | 11125 Dunn Rd, Saint Louis, MO 63136-6132 | 2014-05-17 |
| 1073923413 | Veronica Smotherson | Case Manager/Care Coordinator | 11125 Dunn Rd, Professional Office Building #2, Saint Louis, MO 63136-6132 | 2014-05-07 |
| 1366862781 | Yi Jiang | Social Worker | 11125 Dunn Rd, Saint Louis, MO 63136-6132 | 2014-04-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518565993 | Dorothy Smith | Home Health | 2531 Nathan Drive, St Louis, MO 63136 | 2020-10-16 |
| 1538784459 | Rita D Wilson | Technician | 9597 Jacobi Ave Bldg 33 Apt 7, Saint Louis, MO 63136 | 2020-06-16 |
| 1922646728 | Eduhealth Personal Care Services | Technician | 5843 Eagle Valley Dr Saint Louis Mo 63136, Saint Louis, MO 63136 | 2019-12-12 |
| 1558912964 | Homers Haven Home Care LLC | Home Health | 5636 Pamplin Pl, St Louis, MO 63136 | 2019-09-26 |
| 1366096703 | Chloe Suzanne Datillo | Nurse Practitioner | 2865 Netherton Dr., St Louis, MO 63136 | 2019-07-24 |
| 1053976431 | U Auto Be Quik LLC | Non-emergency Medical Transport (VAN) | 10352 Castle Drive, St. Louis, MO 63136 | 2019-05-01 |
| 1164945895 | A Plus Home Health Services LLC | Home Health | 9517 Wilson Bridge Drive, Saint Louis, MO 63136 | 2017-07-25 |
| 1184150302 | Fairview Village Adult Day Care LLC | Clinic/Center | 8449 Jennings Station Rd, Fairview Village Adult Day Care, Saint Louis, MO 63136 | 2017-05-08 |
| 1023541182 | Lots of Love Home Health Services | In Home Supportive Care | 4144 Lindell Blvd. Suite 218, Saint Louis, MO 63136 | 2017-04-06 |
| 1912440876 | Carestl Health | Clinic/Center | 7047 Emma Ave, Jennings, MO 63136 | 2016-11-28 |
| Find all providers in zip 63136 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427315423 | Paul Larsen | Internal Medicine | 1027 Bellevue Ave Ste 200, Saint Louis, MO 63117-1851 | 2012-04-13 |
| 1275899718 | Bradley Carl Witbrodt | Internal Medicine | 3023 N Ballas Rd Ste 200, Saint Louis, MO 63131-2330 | 2012-04-10 |
| 1194004952 | Jad Raffoul | Internal Medicine | 1402 S Grand Blvd Fl 14, Saint Louis, MO 63104-1004 | 2011-08-11 |
| 1982999462 | Philip L Mar | Internal Medicine | 3635 Vista Ave Fl 15, Saint Louis, MO 63110-2539 | 2011-06-13 |
| 1255644191 | Rugheed Ghadban | Internal Medicine | 1402 S Grand Blvd Ste 260, Saint Louis, MO 63104-1004 | 2010-07-20 |
| 1962727404 | Tyson E Turner | Internal Medicine | 625 S New Ballas Rd Ste 2015, Saint Louis, MO 63141 | 2010-03-27 |
| 1649468786 | Midwest Cardiovascular, Inc. | Internal Medicine | 1031 Bellevue Ave Ste 200, Saint Louis, MO 63117-1856 | 2007-10-12 |
| 1124225347 | Pradeep Aaron Chandra | Internal Medicine | 11155 Dunn Rd Ste 304e, Saint Louis, MO 63136-6111 | 2007-06-29 |
| 1699856443 | Miguel Angel Paniagua | Internal Medicine | 12414 Lusher Rd, Saint Louis, MO 63138-1456 | 2006-10-18 |
| 1235147109 | Jerome D Cohen | Internal Medicine | 8138 Westmoreland Ave, Provider Enrollment, Saint Louis, MO 63105-3731 | 2006-08-04 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63136 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.