Mark S Dykewicz
Internist - Allergy & Immunology
3691 Rutger St Suite 100
Saint Louis
, Missouri 63110-2515
Mark S Dykewicz
Internist - Allergy & Immunology
3691 Rutger St Suite 100
Saint Louis
, Missouri 63110-2515
(314) 977-8816
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About
Features
Specialties
- Internist - Allergy & Immunology
Languages spoken
- English
Location
First Address
- Mark S Dykewicz
- 1402 S Grand Blvd M157
- Saint Louis, MO
- Zip : 63104-1004
- Fax : (314) 977-8816
- Phone : (314) 977-8828
Second Address
- Mark S Dykewicz
- 3691 Rutger St Suite 100
- Saint Louis, MO
- Zip : 63110-2515
- Fax : (314) 977-9770
- Phone : (314) 977-9050
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RA0201X | Internist - Allergy & Immunology | R3N72 | MO |
National Provider Identifier
| NPI | 1518971092 |
|---|---|
| Provider Name | Mark S Dykewicz |
| First Address | Saint Louis, MO 63104-1004 |
| Second Address | Saint Louis, MO 63110-2515 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 28/07/2006 |
| Last Update Date | 01/04/2015 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.