Individual
DR. MICHAEL G KOENIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
621 S NEW BALLAS RD STE 2003B, SAINT LOUIS, MO 63141-8265
(314) 251-5811
(314) 251-5812
Mailing address
PO BOX 776084, CHICAGO, IL 60677-6084
(314) 251-5811
(314) 251-5812
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036136533
IL
208000000X
Pediatrics Physician
2010003226
MO
2080P0214X
Pediatric Pulmonology Physician
2010003226
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720171093
—
MO
05
—
2484440
—
OH
Enumeration date
10/01/2006
Last updated
05/06/2024
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