Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 2015002406 | MO |
N | 208000000X | Pediatrician | 2015002406 | MO |
Y | 2080P0203X | Pediatric Critical Care Doctor | 2015002406 | MO |
NPI | 1235345042 |
---|---|
Provider Name | Dr. Kenneth Eugene Remy |
First Address | Saint Louis, MO 63110-1002 |
Second Address | Saint Louis, MO 63110-1002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2007 |
Last Update Date | 15/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200020315 | (05) | MO |