Healthcare Provider Details

I. General information

NPI: 1356800494
Provider Name (Legal Business Name): ANNE MARIE KERCHBERGER MD, M. ENG.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2019
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 N NEW BALLAS RD STE 270
SAINT LOUIS MO
63141-6836
US

IV. Provider business mailing address

450 N NEW BALLAS RD STE 270
SAINT LOUIS MO
63141-6836
US

V. Phone/Fax

Practice location:
  • Phone: 314-991-6969
  • Fax:
Mailing address:
  • Phone: 314-991-6969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number2025024130
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: