Crestwood Affton Medical Center P C

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

CRESTWOOD AFFTON MEDICAL CENTER P C

Practice address

533 Couch Ave Ste 281
Kirkwood, MO 63122-5561

Phone

(314) 965-2322

NPI assigned

Mar 29, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Milton Kardesch

Title

President

Phone

(314) 965-2322

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720108350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "533 COUCH AVE STE 281",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631225561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "533 COUCH AVE STE 281",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631225561",
            "telephone_number": "314-965-2322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESTWOOD AFFTON MEDICAL CENTER P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KARDESCH",
        "authorized_official_first_name": "MILTON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-965-2322",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Kirkwood, MO
• Providers in Kirkwood, MO by specialty
• Internal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.