Organization
DAVID J. PERNIKOFF, MD, PC
Active
Organization
DAVID J. PERNIKOFF, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID J. PERNIKOFF M.D. (PRESIDENT)
(314) 653-1600
Entity
Organization
Contact information
Practice address
2865 NETHERTON DR, SAINT LOUIS, MO 63136-4674
(314) 653-1600
Mailing address
PO BOX 419161, CREVE COEUR, MO 63141-9141
(314) 432-2580
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MO36099
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
506345107
—
MO
01
—
DG4189
RAILROAD MEDICARE
MO
Enumeration date
09/10/2007
Last updated
02/22/2008
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