Nettesheim, Kevin A

Nettesheim, Kevin A is an sole proprietor health care provider with primary practice located at 4305 Butler Hill Rd Ste B , Saint Louis MO 63128-3718. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. Nettesheim, Kevin A can be contacted via phone (314) 849-9009.

Contact Information

Primary practice address
4305 Butler Hill Rd Ste B Saint Louis MO 63128-3718
Phone: (314) 849-9009
Fax: (314) 849-9004
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 000531 Missouri

Profile Details

NPI number 1366445314
LBN Legal business name Nettesheim, Kevin A
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 23rd, 2005
Last updated Apr 28th, 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 1366445314 NPPES
Missouri Other 104946-003 BLUE CROSS/BLUE SHIELD
Missouri Other 4443980001 BLUE CROSS/BLUE SHIELD
Missouri Other 480033520 BLUE CROSS/BLUE SHIELD
Missouri Other 107843 BLUE CROSS/BLUE SHIELD
Missouri MEDICAID 308054006 BLUE CROSS/BLUE SHIELD

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