Provider Demographics
NPI:1043898505
Name:KLASS, ANNA ANDREEVNA (MD)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:ANDREEVNA
Last Name:KLASS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 776084
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-7309
Mailing Address - Country:US
Mailing Address - Phone:636-939-0648
Mailing Address - Fax:636-477-4914
Practice Address - Street 1:107 PIPER HILL DR STE 100
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-1651
Practice Address - Country:US
Practice Address - Phone:636-939-0648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-29
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2024026908207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine