Individual provider · Type 1 NPI
Judith K. Mickelson, MD
Cardiovascular Disease Physician · Cottleville, MO
NPI number
1700876190
Active
Practice location
117 Trail Creek Ct
Cottleville, MO 63304-7594
Other practice locations
- 915 N Grand Blvd, St. Louis, MO 63106-1621 · (314) 652-4100
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Specialist | 174400000X | 35-078636 (OH) |
| Specialist | 174400000X | MD24100 (ME) |
| Cardiovascular Disease Physician | 207RC0000X | 35-078636 (OH) |
| Cardiovascular Disease Physician Primary | 207RC0000X | 2017039388 (MO) |
Cardiovascular Disease Physician: An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
About NPI 1700876190
Judith K. Mickelson, MD's National Provider Identifier is 1700876190, issued on Oct 26, 2005. The primary taxonomy on file is Cardiovascular Disease Physician (207RC0000X), and the practice location is in Cottleville, MO. The record was last updated on Mar 12, 2025.