Healthcare Provider Details

I. General information

NPI: 1801424106
Provider Name (Legal Business Name): OLGA POSTOVITENKO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2020
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 S NEW BALLAS RD STE 437A
SAINT LOUIS MO
63141-8259
US

IV. Provider business mailing address

621 S NEW BALLAS RD STE 437A
SAINT LOUIS MO
63141-8259
US

V. Phone/Fax

Practice location:
  • Phone: 314-251-6344
  • Fax: 314-251-7929
Mailing address:
  • Phone: 314-251-6344
  • Fax: 314-251-7929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number2024048619
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: