Doctor Name: | ADAM M. RALKO |
NPI Number: | 1265751119 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 4301096219 |
Business Practice Address: | 1000 Des Peres Rd Suite 310 Des Peres, MO - 631312050 |
Business Phone Number: | 3148211313 |
Business Fax Number: | |
Mailing Address: | 1000 Des Peres Rd, Suite 310 DES PERES |
State: | MO |
Postal Code: | 631312050 |
Phone Number: | 3148211313 |
Fax Number: | |
NPI Enumeration Date: | 05/18/2010 |
NPI Last Update Date: | 01/23/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 4301096219 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MI |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |