MEDICARE: KNIGHT INTERNISTS, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	26712	MO
2	207R00000X	Internal Medicine Physician	26712	MO

General Provider Information

NPI Number	:	1184803579
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KNIGHT INTERNISTS, INC

Provider Business Mailing Address
First Line	:	1035 BELLEVUE AVE
Second Line	:	SUITE 205
City	:	ST. LOUIS
State	:	MO
Zip	:	63117-1844
Country	:	US
Telephone Number	:	314-645-3400
Fax Number	:	314-645-3344

Provider Business Practice Location Address
First Line	:	1035 BELLEVUE AVE
Second Line	:	SUITE 205
City	:	ST. LOUIS
State	:	MO
Zip	:	63117-1844
Country	:	US
Telephone Number	:	314-645-3400
Fax Number	:	314-645-3344

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. VIVIAN LORRAINE MCCREE
Credential	:
Telephone Number	:	314-645-3400

Provider Enumeration Date	:	11/01/2007
Last Update Date	:	11/01/2007

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Directions to “KNIGHT INTERNISTS, INC ” Practice Location

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