Individual
DR. ANDREW BRIAN KICHURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1402 S GRAND BLVD, FDT 14TH FLOOR, SAINT LOUIS, MO 63104-1004
(314) 577-8762
Mailing address
1402 S GRAND BLVD, FDT 14TH FLOOR, SAINT LOUIS, MO 63104-1004
(314) 577-8762
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2012017263
MO
390200000X
Student in an Organized Health Care Education/Training Program
2012017263
MO
Other
Enumeration date
06/13/2012
Last updated
10/23/2020
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