Basic Information
Provider Information
NPI: 1881625390
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DIRINGER
FirstName: MICHAEL
MiddleName: N
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 660 S EUCLID AVE
Address2: C B 8111
City: SAINT LOUIS
State: MO
PostalCode: 631101010
CountryCode: US
TelephoneNumber: 3143622999
FaxNumber: 3143626033
Practice Location
Address1: 1 BARNES JEWISH HOSPITAL PLZ
Address2:  
City: SAINT LOUIS
State: MO
PostalCode: 631101003
CountryCode: US
TelephoneNumber: 3143622999
FaxNumber: 3143626033
Other Information
ProviderEnumerationDate: 07/05/2006
LastUpdateDate: 11/02/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0200X101534MOY Allopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
2084N0400X101534MON Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
2084V0102X101534MON Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology

ID Information
IDTypeStateIssuerDescription
04501010105MO MEDICAID


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