Organization
KEVIN T ENGER MD PC
Active
Organization
KEVIN T ENGER MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN T ENGER MD PC (OWNER DOCTOR)
(636) 931-5080
Entity
Organization
Contact information
Practice address
1400 US HWY 61, SUITE 310, FESTUS, MO 63028-4137
(636) 931-5080
(636) 937-7321
Mailing address
1400 US HIGHWAY 61, SUITE 310, FESTUS, MO 63028-4100
(636) 931-5080
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
112850
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209004209
—
MO
Enumeration date
05/22/2007
Last updated
06/30/2011
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