Provider Demographics
NPI:1609168160
Name:KRITS, IGOR (MD)
Entity type:Individual
Prefix:
First Name:IGOR
Middle Name:
Last Name:KRITS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 SAINT LUKES CENTER DR
Mailing Address - Street 2:ATTN: DEBBIE
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-3509
Mailing Address - Country:US
Mailing Address - Phone:314-576-2475
Mailing Address - Fax:
Practice Address - Street 1:232 S WOODS MILL RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-3417
Practice Address - Country:US
Practice Address - Phone:314-205-6736
Practice Address - Fax:314-576-2319
Is Sole Proprietor?:No
Enumeration Date:2011-05-03
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2005022721207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO149920052Medicare PIN