Basic Information
| Provider Information | |||||||||
| NPI: | 1992859433 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ORPHE-HARRIS | ||||||||
| FirstName: | CORA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | ORPHE | ||||||||
| OtherFirstName: | CORA | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | M.D. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 723 CHANCELLOR HEIGHTS | ||||||||
| Address2: | |||||||||
| City: | MANCHESTER | ||||||||
| State: | MO | ||||||||
| PostalCode: | 63011 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6362276982 | ||||||||
| FaxNumber: | 3145254868 | ||||||||
| Practice Location | |||||||||
| Address1: | ST ANTHONY'S MEDICAL CENTER | ||||||||
| Address2: | 10010 KENNERLY RD | ||||||||
| City: | ST. LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 63128 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3145254070 | ||||||||
| FaxNumber: | 3145254868 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/22/2007 | ||||||||
| LastUpdateDate: | 03/12/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207PP0204X | R7J56 | MO | Y | Allopathic & Osteopathic Physicians | Emergency Medicine | Pediatric Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 930024410 | 01 | RAILROAD | OTHER | 1992859433 | 05 | MO | MEDICAID |