Provider Demographics
NPI:1992859433
Name:ORPHE-HARRIS, CORA (MD)
Entity Type:Individual
Prefix:DR
First Name:CORA
Middle Name:
Last Name:ORPHE-HARRIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CORA
Other - Middle Name:
Other - Last Name:ORPHE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:723 CHANCELLOR HEIGHTS
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MO
Mailing Address - Zip Code:63011
Mailing Address - Country:US
Mailing Address - Phone:636-227-6982
Mailing Address - Fax:314-525-4868
Practice Address - Street 1:ST ANTHONY'S MEDICAL CENTER
Practice Address - Street 2:10010 KENNERLY RD
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128
Practice Address - Country:US
Practice Address - Phone:314-525-4070
Practice Address - Fax:314-525-4868
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR7J56207PP0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PP0204XAllopathic & Osteopathic PhysiciansEmergency MedicinePediatric Emergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
930024410OtherRAILROAD
MO1992859433Medicaid
E56955Medicare UPIN