Provider Demographics
NPI:1316994460
Name:MWINTSHI, KABEYA (MD)
Entity type:Individual
Prefix:
First Name:KABEYA
Middle Name:
Last Name:MWINTSHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10004 KENNERLY RD
Mailing Address - Street 2:SUITE 374B
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-2141
Mailing Address - Country:US
Mailing Address - Phone:314-842-9669
Mailing Address - Fax:314-842-1017
Practice Address - Street 1:10004 KENNERLY RD
Practice Address - Street 2:SUITE 374B
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-2141
Practice Address - Country:US
Practice Address - Phone:314-842-9669
Practice Address - Fax:314-842-1017
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2006001779207P00000X
MO200600001779207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1316994460Medicaid
I51850Medicare UPIN
MO156580014Medicare PIN
MO134310001Medicare PIN