Provider Demographics
NPI:1477539633
Name:PIEKARSKI, DONALD (DPM)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:
Last Name:PIEKARSKI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8420 DELMAR BLVD
Mailing Address - Street 2:S 205
Mailing Address - City:ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63124-2177
Mailing Address - Country:US
Mailing Address - Phone:314-991-0506
Mailing Address - Fax:314-991-0506
Practice Address - Street 1:8420 DELMAR BLVD
Practice Address - Street 2:S 205
Practice Address - City:ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63124-2177
Practice Address - Country:US
Practice Address - Phone:314-991-0506
Practice Address - Fax:314-991-0506
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-20
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO000378213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
000021101Medicare ID - Type Unspecified
T48265Medicare UPIN