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DR. ROBERT G KOPITSKY MD
Cardiovascular Disease >> Internal Medicine >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1831182807
Individual Registrant:DR. ROBERT G KOPITSKY MD
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
3023 N BALLAS RD STE 200D SAINT LOUIS, MO 63131-2328 US
Tel: 314-996-7272 Fax: --
Tel: 314-996-7272 Fax: --
Contact information for business:
3023 N BALLAS RD STE 200D SAINT LOUIS, MO 63131-2328 US
Tel: 314-996-7272 Fax: --
Tel: 314-996-7272 Fax: --
Registration Information:
NPI: 1831182807
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 207RC0000X | Allopathic & Osteopathic Physicians Internal Medicine Cardiovascular Disease | MO | R4E32 |
| Y | 207RI0011X | Allopathic & Osteopathic Physicians Internal Medicine | MO | R4E32 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| RR MEDICARE NUMBER | 060042993 | MO | 01 |
| CCL INDIVDUAL PROVIDER NUMBER | MA1080003 | MO | 01 |
| MEDICARE PROV ID AREA 99 | 003013185 | MO | 01 |
| RR GROUP 01 | CD6536 | MO | 01 |
| CATHLAB RR MCARE | P00275849 | MO | 01 |
| CCL MEDICARE GROUP NUMBER | MA1080 | 01 | |
| MCARE CCL GROUP NUMBER | 000047049 | MO | 01 |
| MEDICARE PROVIDER ID | 002012762 | MO | 01 |
