Organization
CHESTERFIELD PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DARRYL S COHEN D.O. (PRESIDENT)
(636) 519-8899
Entity
Organization
Contact information
Practice address
16216 BAXTER ROAD, SUITE 310, CHESTERFIELD, MO 63017
(636) 519-8899
(636) 519-0011
Mailing address
16216 BAXTER ROAD, SUITE 310, CHESTERFIELD, MO 63017
(636) 519-8899
(636) 519-0011
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
RIC34
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
501104707
—
MO
Enumeration date
05/16/2007
Last updated
10/15/2008
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