Organization
BORIS KHARITON MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JOELLEN HARTZELL (OFFICE MANAGER)
(314) 667-5535
Entity
Organization
Contact information
Practice address
70 JUNGERMANN CIR STE 302, SAINT PETERS, MO 63376-1637
(314) 667-5535
(314) 261-5010
Mailing address
PO BOX 411091, SAINT LOUIS, MO 63141-3091
(314) 667-5535
(314) 261-5010
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
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
Enumeration date
04/10/2007
Last updated
06/18/2025
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