Healthcare Provider Details

I. General information

NPI: 1992859433
Provider Name (Legal Business Name): CORA ORPHE-HARRIS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CORA ORPHE M.D.

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 03/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ST ANTHONY'S MEDICAL CENTER 10010 KENNERLY RD
ST. LOUIS MO
63128
US

IV. Provider business mailing address

723 CHANCELLOR HEIGHTS
MANCHESTER MO
63011
US

V. Phone/Fax

Practice location:
  • Phone: 314-525-4070
  • Fax: 314-525-4868
Mailing address:
  • Phone: 636-227-6982
  • Fax: 314-525-4868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PP0204X
TaxonomyPediatric Emergency Medicine (Emergency Medicine) Physician
License NumberR7J56
License Number StateMO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier930024410
Identifier TypeOTHER
Identifier State
Identifier IssuerRAILROAD
# 2
Identifier1992859433
Identifier TypeMEDICAID
Identifier StateMO
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: