Kistler, Walter David

Kistler, Walter David is an sole proprietor health care provider with primary practice located at 950 Francis Pl S-113, Saint Louis MO 63105-2465. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Kistler, Walter David can be contacted via phone (314) 721-0411.

Contact Information

Primary practice address
950 Francis Pl S-113 Saint Louis MO 63105-2465
Phone: (314) 721-0411
Fax: (314) 721-5968
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X R3878 Missouri

Profile Details

NPI number 1922005834
LBN Legal business name Kistler, Walter David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 7th, 2005
Last updated May 11th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922005834 NPPES
Other 431059684 FED TAX ID
Other 186857 FED TAX ID
MEDICAID 200690907 FED TAX ID
Other 178790 FED TAX ID
Other P00174135 FED TAX ID
Other 000003759 FED TAX ID

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