Dennis M Balfe, MD

Individual provider Active NPI Diagnostic Radiology Physician · Saint Louis, MO

NPI 1811919954 · NPPES record last updated Jan 24, 2018

Key facts

NPI
1811919954
Entity type
Individual (NPI type 1)
Primary specialty
Diagnostic Radiology Physician 2085R0202X
License
R9661 (MO)
Practice address
510 S Kingshighway Blvd
Saint Louis, MO 63110-1016
Phone
(314) 362-7200
Fax
(314) 747-4189
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X R9661 MO Yes

Addresses

Primary practice location

510 S Kingshighway Blvd
Saint Louis, MO 63110-1016

Mailing address

660 S Euclid Ave
C B 8131
Saint Louis, MO 63110-1010
Phone (314) 362-7200

Other identifiers

IdentifierTypeStateIssuer
ENROLLEDMedicaidIL
209723402MedicaidMO

Other providers in Saint Louis, MO

All providers in Saint Louis, MO · Diagnostic Radiology Physician in Missouri

Sources for this page

Verify at the official NPI Registry.