Individual
DR. GEORGE M KICHURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11155 DUNN RD, SUITE 304E, SAINT LOUIS, MO 63136-6150
(314) 741-0911
(314) 653-3671
Mailing address
11155 DUNN RD, SUITE 304E, SAINT LOUIS, MO 63136-6150
(314) 741-0911
(314) 653-3671
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
036-089747
IL
207RC0000X
Cardiovascular Disease Physician
R7H84
MO
207RI0011X
Interventional Cardiology Physician
036089474
IL
207RI0011X
Interventional Cardiology Physician
Primary
R7H84
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207725672
—
MO
05
—
65466808
—
IL
Enumeration date
12/19/2005
Last updated
12/06/2021
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