Midwest Internists, PC

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

105483 Issued in MO

Legal business name

MIDWEST INTERNISTS, PC

Practice address

1040 N Mason Rd
Suite 102
Saint Louis, MO 63141-6399

Phone

(314) 996-8349

NPI assigned

Jul 17, 2007

Last updated

Jul 17, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kamal R. Demetry

Title

President

Phone

(314) 996-8349

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184630400000",
    "number": "1790984904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 N MASON RD",
            "address_2": "SUITE 102",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416399",
            "telephone_number": "314-996-8349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 N MASON RD",
            "address_2": "SUITE 102",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416399",
            "telephone_number": "314-996-8349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST INTERNISTS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-17",
        "last_updated": "2007-07-17",
        "status": "A",
        "authorized_official_last_name": "DEMETRY",
        "authorized_official_first_name": "KAMAL",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-996-8349",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MO",
            "license": "105483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Endocrinology, Diabetes & Metabolism Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Endocrinology, Diabetes & Metabolism Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2007; 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.