Active NPI
Mark Udey, MD
- Dermatology Physician
- Saint Louis, MO
National Provider Identifier
1346372109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- R2F14
- Practice address
- 4921 Parkview PL Ste 5a
Ste 5a
Saint Louis, MO 63110-1032 - Phone
- (314) 362-2643
- Fax
- (314) 747-8693
- NPI assigned
- Mar 9, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | R2F14 | MO | Primary |
Addresses
Primary practice location
4921 Parkview PL Ste 5a
Ste 5a
Saint Louis, MO 63110-1032
Mailing address
660 S Euclid Ave
C B 8123
Saint Louis, MO 63110-1010
Phone (314) 362-2643
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517184000000",
"number": "1346372109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "660 S EUCLID AVE",
"address_2": "C B 8123",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631101010",
"telephone_number": "314-362-2643",
"fax_number": "314-747-8693"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4921 PARKVIEW PL STE 5A",
"address_2": "STE 5A",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631101032",
"telephone_number": "314-362-2643",
"fax_number": "314-747-8693"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UDEY",
"first_name": "MARK",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-09",
"last_updated": "2018-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "MO",
"license": "R2F14",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.