Healthcare Provider Details

I. General information

NPI: 1619981685
Provider Name (Legal Business Name): COMPREHENSIVE CARDIOVASCULAR CONSULTANTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 09/02/2025
Certification Date: 11/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3760 S LINDBERGH BLVD STE 101
SAINT LOUIS MO
63127-1374
US

IV. Provider business mailing address

PO BOX 1209
MARYLAND HEIGHTS MO
63043-0209
US

V. Phone/Fax

Practice location:
  • Phone: 314-849-0923
  • Fax: 314-849-5716
Mailing address:
  • Phone: 314-849-0923
  • Fax: 314-849-5716

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: RAFFI KRIKORIAN
Title or Position: OWNER
Credential: MD
Phone: 314-849-0923