Healthcare Provider Details

I. General information

NPI: 1457348286
Provider Name (Legal Business Name): KIRA S MAILEY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KIRA STERNMAILEY M.D.

II. Dates (important events)

Enumeration Date: 10/06/2005
Last Update Date: 03/08/2021
Certification Date: 03/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 CHAPEL HILL EST
SAINT LOUIS MO
63131-1315
US

IV. Provider business mailing address

PO BOX 368
SAINT PETERS MO
63376-0007
US

V. Phone/Fax

Practice location:
  • Phone: 636-939-3166
  • Fax: 636-939-3356
Mailing address:
  • Phone: 636-928-0078
  • Fax: 636-928-0089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberR8C99
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: