Individual
DR. KENAN RIFAT OMURTAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4444 FOREST PARK AVE, DIV OB REPRODUCTIVE ENDOCRINOLOGY, STE 3100, SAINT LOUIS, MO 63108-2212
(314) 286-2400
(314) 286-2455
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 286-2400
(314) 286-2455
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
2010006162
MO
207VE0102X
Reproductive Endocrinology Physician
Primary
2010006162
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209173608
—
MO
Enumeration date
12/31/2007
Last updated
04/17/2025
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