Individual
DR. DZMITRY MATSIUKEVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 CHILDRENS PL, DIV PED CRITICAL CARE MED, SAINT LOUIS, MO 63110-1002
(314) 454-2527
(314) 747-8880
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 454-2527
(314) 747-8880
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
2019024454
MO
2080P0202X
Pediatric Cardiology Physician
2019024454
MO
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
2019024454
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200072068
—
MO
Enumeration date
07/22/2011
Last updated
04/17/2025
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