MEDICARE: FELICIA L. HARVEY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	2001023410	MO

General Provider Information

NPI Number	:	1033145982
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FELICIA L. HARVEY MD

Provider Business Mailing Address
First Line	:	5701 DELMAR BLVD
Second Line	:
City	:	ST. LOUIS
State	:	MO
Zip	:	63112-0937
Country	:	US
Telephone Number	:	314-367-7848
Fax Number	:	314-367-5608

Provider Business Practice Location Address
First Line	:	11642 WEST FLORISSANT
Second Line	:
City	:	ST. LOUIS
State	:	MO
Zip	:	63033
Country	:	US
Telephone Number	:	314-838-8220
Fax Number	:	314-838-8091

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2006
Last Update Date	:	08/03/2011

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