Provider Demographics
NPI:1316916745
Name:VOGES, CHAD MORRIS (MD)
Entity type:Individual
Prefix:
First Name:CHAD
Middle Name:MORRIS
Last Name:VOGES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 OLYMPIC WAY
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-1664
Mailing Address - Country:US
Mailing Address - Phone:636-244-2373
Mailing Address - Fax:
Practice Address - Street 1:103 OLYMPIC WAY
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-1664
Practice Address - Country:US
Practice Address - Phone:636-244-2373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01052730A207Q00000X
MO2007016904207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOP00682629OtherRAILROAD MEDICARE
IN000000228894OtherANTHEM PROVIDER NUMBER
IN200304220Medicaid
IN11438208OtherCAQH NUMBER
MO1316916745Medicaid
IN9397572OtherPHCS PID NUMBER
IN090670KMedicare PIN
IN815490CCCMedicare PIN
IN815520KKKKMedicare PIN
IN199190NMedicare PIN
MOP00682629OtherRAILROAD MEDICARE
IN080189781Medicare ID - Type UnspecifiedRAILROAD MEDICARE NUMBER
IN11438208OtherCAQH NUMBER
IN815510JJJMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
IN815500E5Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
IN200304220Medicaid