Provider Demographics
NPI:1679612923
Name:KERNER, ATTILA (MD)
Entity Type:Individual
Prefix:DR
First Name:ATTILA
Middle Name:
Last Name:KERNER
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 1:9449 DENNISON GROVE CT
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63126-3063
Mailing Address - Country:US
Mailing Address - Phone:706-631-1499
Mailing Address - Fax:
Practice Address - Street 1:PO BOX: 8054. 660 S. EUCLID
Practice Address - Street 2:WASHINGTON UNIV SCHOOL OF MED., DEPT OF ANESTHESIOLOGY
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110
Practice Address - Country:US
Practice Address - Phone:314-362-6978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008021947207L00000X
MO2010026214207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA97BBHCTMedicare UPIN