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Organization
NETTESHEIM FAMILY FOOT CARE, P.C.
Active
Organization
NETTESHEIM FAMILY FOOT CARE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN A NETTESHEIM D.P.M. (OWNER)
(314) 849-9009
Entity
Organization
Contact information
Practice address
4305 BUTLER HILL RD, SUITE B, SAINT LOUIS, MO 63128-3718
(314) 849-9009
(314) 849-9004
Mailing address
4305 BUTLER HILL RD STE B, SAINT LOUIS, MO 63128-3718
(314) 849-9009
(314) 849-9004
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
000531
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102788
GROUP HEALTH PLAN
—
01
—
104946-003
BLUECROSS BLUESHIED OF MI
MO
01
—
107843
HEALTHLINK
—
05
—
308054006
—
MO
01
—
990001711
MEDICARE ID
MO
Enumeration date
07/11/2007
Last updated
05/08/2015
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