Provider Demographics
NPI:1528024544
Name:ARCIDI, JOSEPH MICHAEL JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:MICHAEL
Last Name:ARCIDI
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:12855 N 40 DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8657
Mailing Address - Country:US
Mailing Address - Phone:314-880-6162
Mailing Address - Fax:314-880-6184
Practice Address - Street 1:10012 KENNERLY RD
Practice Address - Street 2:SUITE 300
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-2197
Practice Address - Country:US
Practice Address - Phone:314-842-0602
Practice Address - Fax:314-842-4372
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2021-10-14
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Provider Licenses
StateLicense IDTaxonomies
MO2014015598208G00000X
MI4301097553208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1528024544Medicaid
MO1528024544Medicaid
CAWC50460AMedicare ID - Type Unspecified