Individual
DR. MATTHEW J KOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4550 MEMORIAL DR STE 280, BELLEVILLE, IL 62226-5372
(618) 767-3235
(618) 433-6470
Mailing address
4550 MEMORIAL DR STE 280, BELLEVILLE, IL 62226-5372
(618) 767-3235
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
036121947
IL
207RN0300X
Nephrology Physician
2002009358
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
205799000
—
MO
Enumeration date
07/17/2006
Last updated
03/11/2026
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