Healthcare Provider Details

I. General information

NPI: 1811482250
Provider Name (Legal Business Name): ANNA BAILEY BERKLEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2018
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 BJC SAINT PETERS DR STE 100
SAINT PETERS MO
63376-3386
US

IV. Provider business mailing address

PO BOX 959354
SAINT LOUIS MO
63195-9354
US

V. Phone/Fax

Practice location:
  • Phone: 636-916-7233
  • Fax: 636-916-7234
Mailing address:
  • Phone: 636-916-7233
  • Fax: 636-916-7234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2021011320
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number2021011320
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: