Healthcare Provider Details

I. General information

NPI: 1396184545
Provider Name (Legal Business Name): CHRISTOPHER JUNG RIGELL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2013
Last Update Date: 04/08/2024
Certification Date: 04/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 N GRAND BLVD
SAINT LOUIS MO
63106-1621
US

IV. Provider business mailing address

915 N GRAND BLVD
SAINT LOUIS MO
63106-1621
US

V. Phone/Fax

Practice location:
  • Phone: 314-652-4100
  • Fax: 314-289-6389
Mailing address:
  • Phone: 314-652-4100
  • Fax: 314-289-6389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License Number2016013403
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: