Healthcare Provider Details

I. General information

NPI: 1790756104
Provider Name (Legal Business Name): KARTH ANTONY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2006
Last Update Date: 11/16/2025
Certification Date: 11/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10004 KENNERLY RD STE 361B
SAINT LOUIS MO
63128-2141
US

IV. Provider business mailing address

10004 KENNERLY RD STE 361B
SAINT LOUIS MO
63128-2141
US

V. Phone/Fax

Practice location:
  • Phone: 314-843-3449
  • Fax: 314-843-8762
Mailing address:
  • Phone: 314-843-3449
  • Fax: 314-843-8762

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number2001004843
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: