Provider Demographics
NPI:1023218278
Name:KALVAITIS, SAULIUS (MD)
Entity Type:Individual
Prefix:DR
First Name:SAULIUS
Middle Name:
Last Name:KALVAITIS
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 1:11155 DUNN RD STE 304E
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63136-6111
Mailing Address - Country:US
Mailing Address - Phone:314-741-0911
Mailing Address - Fax:314-653-3671
Practice Address - Street 1:11155 DUNN RD STE 304E
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63136-6111
Practice Address - Country:US
Practice Address - Phone:314-741-0911
Practice Address - Fax:314-653-3671
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-24
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101231950207RC0000X
IL036092508207RC0001X
MO2011003932207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1023218278Medicaid
IL36092508Medicaid