Provider Demographics
NPI:1710954300
Name:KRIKORIAN, RAFFI K (MD)
Entity Type:Individual
Prefix:DR
First Name:RAFFI
Middle Name:K
Last Name:KRIKORIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1209
Mailing Address - Street 2:
Mailing Address - City:MARYLAND HEIGHTS
Mailing Address - State:MO
Mailing Address - Zip Code:63043-0209
Mailing Address - Country:US
Mailing Address - Phone:314-849-0923
Mailing Address - Fax:314-849-5716
Practice Address - Street 1:3760 S LINDBERGH BLVD STE 101
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63127-1374
Practice Address - Country:US
Practice Address - Phone:314-849-0923
Practice Address - Fax:314-849-5716
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-02
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOR4P45207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO060062058OtherRAILROAD
MO203014824Medicaid
MOE85667Medicare UPIN
MO203014824Medicaid
MO327395476Medicare PIN
MO060062058OtherRAILROAD