Provider Demographics
NPI:1336147602
Name:KNAPIK, DENNIS M JR (MD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:M
Last Name:KNAPIK
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4650 CHIPPEWA ST
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63116-1611
Mailing Address - Country:US
Mailing Address - Phone:314-449-9730
Mailing Address - Fax:314-449-9731
Practice Address - Street 1:4650 CHIPPEWA ST
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63116-1611
Practice Address - Country:US
Practice Address - Phone:314-449-9730
Practice Address - Fax:314-449-9731
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2023-10-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CODR.0071908207R00000X
MO108559207RG0300X, 207QG0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO203859707Medicaid
MO203859707Medicaid
9319Medicare ID - Type Unspecified