Individual
DR. DANIEL DESTA BEKELE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6113 RIDGE AVE, SAINT LOUIS, MO 63133-2616
(314) 230-9050
(855) 281-8576
Mailing address
6113 RIDGE AVE, SAINT LOUIS, MO 63133-2616
(314) 230-9050
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
2017038037
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
210056543
—
MO
Enumeration date
10/24/2017
Last updated
07/23/2026
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