Provider Demographics
NPI:1881798361
Name:CARDIOLOGY CONSULTANTS OF ST. LOUIS COUNTY PC
Entity type:Organization
Organization Name:CARDIOLOGY CONSULTANTS OF ST. LOUIS COUNTY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ARLETA
Authorized Official - Middle Name:
Authorized Official - Last Name:KAISER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-270-3913
Mailing Address - Street 1:13303 TESSON FERRY RD
Mailing Address - Street 2:STE. 55
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-4062
Mailing Address - Country:US
Mailing Address - Phone:317-270-3260
Mailing Address - Fax:314-270-3259
Practice Address - Street 1:13303 TESSON FERRY RD
Practice Address - Street 2:STE. 55
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-4062
Practice Address - Country:US
Practice Address - Phone:317-270-3260
Practice Address - Fax:314-270-3259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000011397Medicare ID - Type Unspecified