Provider Demographics
NPI:1700370996
Name:HARVEY-FELDEWERTH, KATHRYN EMILY (DO)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:EMILY
Last Name:HARVEY-FELDEWERTH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:KATHRYN
Other - Middle Name:EMILY
Other - Last Name:HARVEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:15945 CLAYTON RD STE 310
Mailing Address - Street 2:
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63011-2493
Mailing Address - Country:US
Mailing Address - Phone:636-256-5181
Mailing Address - Fax:636-256-5370
Practice Address - Street 1:15945 CLAYTON RD STE 310
Practice Address - Street 2:
Practice Address - City:BALLWIN
Practice Address - State:MO
Practice Address - Zip Code:63011-2493
Practice Address - Country:US
Practice Address - Phone:636-256-5181
Practice Address - Fax:636-256-5370
Is Sole Proprietor?:No
Enumeration Date:2018-06-20
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020030345207R00000X
MO2018021036207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty