Provider Demographics
NPI:1093860652
Name:DAY, CAROLINE ELIZABETH (MD, MPH)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:ELIZABETH
Last Name:DAY
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4352 MANCHESTER AVE
Mailing Address - Street 2:FAMILY CARE HEALTH CENTER, FOREST PARK SOUTHEAST
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-2138
Mailing Address - Country:US
Mailing Address - Phone:314-531-5444
Mailing Address - Fax:314-531-0063
Practice Address - Street 1:401 HOLLY HILLS AVE
Practice Address - Street 2:FAMILY CARE HEALTH CENTER ADMINISTRATION
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63111-2410
Practice Address - Country:US
Practice Address - Phone:314-481-1615
Practice Address - Fax:314-353-1310
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2014-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA64950207Q00000X
MO200702054207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A649500Medicaid
MO207543000Medicaid
G42470Medicare UPIN
CA00A649500Medicaid