Healthcare Provider Details

I. General information

NPI: 1922758184
Provider Name (Legal Business Name): MIKEALA BEKEMEIER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2022
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10018 KENNERLY RD
SAINT LOUIS MO
63128-2106
US

IV. Provider business mailing address

10018 KENNERLY RD
SAINT LOUIS MO
63128-2106
US

V. Phone/Fax

Practice location:
  • Phone: 314-251-6663
  • Fax: 314-251-8716
Mailing address:
  • Phone: 314-251-6663
  • Fax: 314-251-8716

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number2026031024
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: