Provider Demographics
NPI:1962513903
Name:WAREHALL, KATHRYN C (MD)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:C
Last Name:WAREHALL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3015 N BALLAS RD
Mailing Address - Street 2:EMERGENCY DEPARTMENT
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-2329
Mailing Address - Country:US
Mailing Address - Phone:314-996-5225
Mailing Address - Fax:314-991-0943
Practice Address - Street 1:3015 N BALLAS RD
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-2329
Practice Address - Country:US
Practice Address - Phone:314-996-5225
Practice Address - Fax:314-991-0943
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO114006207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A11549Medicare UPIN