Provider Demographics
NPI:1750323028
Name:MARGHERITA, ANTHONY J (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:J
Last Name:MARGHERITA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 NORTH NEW BALLAS RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141
Mailing Address - Country:US
Mailing Address - Phone:314-432-4999
Mailing Address - Fax:314-432-5088
Practice Address - Street 1:555 NORTH NEW BALLAS RD
Practice Address - Street 2:SUITE 210
Practice Address - City:ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141
Practice Address - Country:US
Practice Address - Phone:314-432-4999
Practice Address - Fax:314-432-5088
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO713120208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
111576OtherB CHOICE
169238OtherGHP
MO111576OtherMO BLUE
2300445OtherUHC
332456OtherHEALTHLINK
MO003014013Medicare PIN
332456OtherHEALTHLINK
P00085306Medicare PIN