Provider Demographics
NPI:1871599811
Name:KAMINSKY, SHARI LEWIS (DPM)
Entity type:Individual
Prefix:DR
First Name:SHARI
Middle Name:LEWIS
Last Name:KAMINSKY
Suffix:
Gender:F
Credentials:DPM
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Mailing Address - Street 1:1224 GRAHAM RD
Mailing Address - Street 2:SUITE 3010
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63031-8028
Mailing Address - Country:US
Mailing Address - Phone:314-355-0074
Mailing Address - Fax:314-355-0337
Practice Address - Street 1:1224 GRAHAM RD
Practice Address - Street 2:SUITE 3010
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63031-8028
Practice Address - Country:US
Practice Address - Phone:314-355-0074
Practice Address - Fax:314-355-0337
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO000648213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO306861618Medicaid
431928131OtherTAX ID
MO306861618Medicaid
MOU16356Medicare UPIN