Provider Demographics
NPI:1821081712
Name:COLE, PATRICIA L (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:L
Last Name:COLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 N NEW BALLAS RD
Mailing Address - Street 2:STE 270 W
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-6835
Mailing Address - Country:US
Mailing Address - Phone:314-991-6969
Mailing Address - Fax:314-997-6969
Practice Address - Street 1:450 N NEW BALLAS RD
Practice Address - Street 2:STE 270 W
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-6835
Practice Address - Country:US
Practice Address - Phone:314-991-6969
Practice Address - Fax:314-997-6969
Is Sole Proprietor?:No
Enumeration Date:2005-08-25
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR1G19207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOCD6536OtherRR GROUP 01
MOMA1080002OtherCCL INDIVDUAL PROVIDER NUMBER
MOP00275849OtherRR CCL GROUP
1801889795OtherSTL GROUP NP
MO001013185OtherMEDICARE PROV ID AREA 99
MO005012762OtherMEDICARE PROVIDER ID
MO060042547OtherRR MEDICARE NUMBER
1124011010OtherHHC CATH GROUP NPI
MO000047049OtherMCARE CCL GROUP NUMBER
MOMA1080OtherCCL MEDICARE GROUP
MOP00847493OtherRAILROAD MEDICARE
MOP00847493OtherRAILROAD MEDICARE
MO147540018Medicare PIN