Healthcare Provider Details

I. General information

NPI: 1235391921
Provider Name (Legal Business Name): MICHAEL JOSEPH DURKIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2008
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 S TAYLOR AVE DIV IM INFECTIOUS DISEASE, STE 100
SAINT LOUIS MO
63110-1035
US

IV. Provider business mailing address

620 S TAYLOR AVE
SAINT LOUIS MO
63110-1035
US

V. Phone/Fax

Practice location:
  • Phone: 314-362-9098
  • Fax: 314-362-9851
Mailing address:
  • Phone: 314-362-9098
  • Fax: 314-362-9851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number2011006547
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: