Organization
COMPREHENSIVE CARDIOVASCULAR CONSULTANTS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAFFI KRIKORIAN MD (OWNER)
(314) 849-0923
Entity
Organization
Contact information
Practice address
3760 S LINDBERGH BLVD, SUITE 101, SAINT LOUIS, MO 63127-1374
(314) 849-0923
(314) 849-5716
Mailing address
3760 S LINDBERGH BLVD, SUITE 101, SAINT LOUIS, MO 63127-1374
(314) 849-0923
(314) 849-5716
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
MDR4P45
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DG2079
RAILROAD MEDICARE
MO
01
—
IL1797
IL MEDICARE IDTF PTAN
IL
01
—
MA1570
MO MEDICARE IDTF PTAN
MO
Enumeration date
07/08/2011
Last updated
07/08/2011
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