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NPI Code Detail

MEDICARE: DANUTA J PIKUL MD

MEDICARE: DANUTA J PIKUL MD
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
1207P00000XEmergency Medicine PhysicianIL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00350421OTHERILRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
108232204OTHERILBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1417930470
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANUTA J PIKUL MD
Provider Business Mailing Address
First Line : PO BOX 66971
Second Line : DEPT LE
City : SAINT LOUIS
State : MO
Zip : 63166-6971
Country : US
Telephone Number : 800-968-6866
Fax Number :
Provider Business Practice Location Address
First Line : 6800 STATE ROUTE 162
Second Line :
City : MARYVILLE
State : IL
Zip : 62062-8500
Country : US
Telephone Number : 800-968-6866
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/23/2005
Last Update Date : 10/22/2007

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