# BORIS KHARITON MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184847246
- **Authorized official:** MRS. JOELLEN HARTZELL (OFFICE MANAGER)
- **Authorized official phone:** (314) 667-5535

## Contact information

- **Practice address:** 70 JUNGERMANN CIR STE 302, SAINT PETERS, MO 63376-1637
- **Practice address phone:** (314) 667-5535
- **Practice address fax:** (314) 261-5010
- **Mailing address:** PO BOX 411091, SAINT LOUIS, MO 63141-3091
- **Mailing address phone:** (314) 667-5535
- **Mailing address fax:** (314) 261-5010

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/10/2007
- **Last updated:** 06/18/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 204975718 | — | MO |
| 01 | — | 250013745 & DN4815 | RAILROAD MEDICARE OF MISSOURI | MO |
| 05 | — | 607509141 | — | IL |
| 01 | — | P00621694 & DN4816 | RAILROAD MEDICARE OF ILLINOIS | IL |