EDWARD STEPHEN BOLESTA (NPI# 1366456840) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1366456840 |
Entity Type | Individual |
Full Name | EDWARD STEPHEN BOLESTA |
Credential | MD |
Practice Address |
1402 S Grand St Louis MO 63104 |
Mailing Address |
3691 Rutger St Saint Louis MO 63110-2515 |
Practice Telephone | 3145778000 |
Mailing Telephone | 3149776828 |
Mailing Fax Number | 3149776777 |
Enumeration Date | 2006-07-28 |
Last Update Date | 2017-01-17 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207ZF0201X |
Pathology Specialization: Forensic Pathology |
36579 | MO | Allopathic & Osteopathic Physicians |
Y | 207ZP0101X |
Pathology Specialization: Anatomic Pathology |
36579 | MO | Allopathic & Osteopathic Physicians |
N | 207ZP0105X |
Pathology Specialization: Clinical Pathology/Laboratory Medicine |
36579 | MO | Allopathic & Osteopathic Physicians |
Street Address |
1402 S GRAND |
City | ST LOUIS |
State | MO |
Zip Code | 63104 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548280969 | Leonard E Grosso | Pathology | 1402 S Grand, St Louis, MO 63110 | 2006-07-20 |
1760591325 | Michael A Graham | Pathology | 1402 S Grand, St Louis, MO 63110 | 2006-08-29 |
1902817562 | Christine M Janney | Pathology | 1402 S Grand, St Louis, MO 63110 | 2006-08-10 |
1073527552 | Nancy J Phillips | Pathology | 1402 S Grand, St Louis, MO 63110 | 2006-07-28 |
1437172616 | Richard G Hoover | Pathology | 1402 S Grand, St Louis, MO 63110 | 2006-07-26 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407469570 | Family Care Health Centers | Clinic/Center | 2717 Sidney Street, St. Louis, MO 63104 | 2020-08-28 |
1023638038 | Laura Ann Humphrey | Physician Assistant | Allied Health Building 3437 Caroline Street, Room 3015, Saint Louis, MO 63104 | 2020-04-20 |
1174187264 | Ahsan Ali | Student in an Organized Health Care Education/Training Program | 1438 South Grand Blvd, Monteleone Hall, St. Louis, MO 63104 | 2019-04-24 |
1205359916 | Brenda Eve Ladin | Behavior Technician | 1221 Allen Market Lane Rear, St. Louis, MO 63104 | 2017-07-25 |
1841722063 | Gustavo G Mendez | Student in an Organized Health Care Education/Training Program | 1465 South Grand Bulevard Rm 2717, Ssm Health Cardinal Glennon Children's Hospital, Saint Louis, MO 63104 | 2017-03-28 |
1053776716 | Carmella Harper | Respiratory Therapist, Certified | 2678 Park Ave, St Louis, MO 63104 | 2015-12-23 |
1922485986 | Alexander Tremont | Internal Medicine | 1402 S Grand Blvd Rm M260, Saint Louis, MO 63104 | 2015-04-29 |
1306233341 | Healthcare R Us | Home Health | 2859 Sidney St, St Louis, MO 63104 | 2015-04-16 |
1396159091 | Daniela Hermelin | Pathology | 1402 South Grane, St. Louis, MO 63104 | 2014-06-20 |
1992117881 | Kelly Denise Durbin | Social Worker | 1920 S 7th St, Saint Louis, MO 63104 | 2014-05-27 |
Find all providers in zip 63104 |
Taxonomy Code | 207ZP0101X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Pathology |
Specialization | Anatomic Pathology |
A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
Notes: Source: American Board of Medical Specialties, 2007. [7/1/2007: definition added, source added, 7/1/2009: defintion reformatted; 7/1/2011: modified source] - Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/. American Osteopathic Board of Pathology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology (note: this taxonomy code identifies the "anatomic pathology only" route). To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902817562 | Christine M Janney | Pathology | 1402 S Grand, St Louis, MO 63110 | 2006-08-10 |
1073527552 | Nancy J Phillips | Pathology | 1402 S Grand, St Louis, MO 63110 | 2006-07-28 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780182915 | Richard L Payne | Pathology | 7 Dunleith Dr, Saint Louis, MO 63124-1895 | 2018-01-23 |
1518389261 | Ralph Paul Mennemeyer | Pathology | 145 N Roby Farm Rd, Rocheport, MO 65279-9437 | 2014-01-15 |
1205056421 | Grant R Kolar | Pathology | 660 S. Euclid, Box 8118, Saint Louis, MO 63108 | 2007-04-27 |
1154447993 | Gustavo Alejandro Alvarez-paiva | Pathology | 121 Saint Lukes Center Dr Ste 406, Chesterfield, MO 63017 | 2007-03-22 |
1386723070 | Roger Alan Reichert | Pathology | 411 Rolling View Rd, Creve Coeur, MO 63141-8641 | 2006-11-03 |
1831188002 | Larry D Lawson | Pathology | 700 Nw Hunter Dr, Blue Springs, MO 64015-7730 | 2005-10-19 |
1326037656 | Mehdi Zarabi | Pathology | 3601 Ne Ralph Powell Rd Ste A, Lees Summit, MO 64064 | 2005-10-19 |
1598769986 | Donald Craig Allred | Pathology | 216 S Kingshighway Blvd, Saint Louis, MO 63110-1026 | 2005-06-13 |
1417574831 | Kasey Kreutz | Pathology | 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110-1003 | 2020-07-01 |
1770100679 | Amanda Oi-yun Wong | Pathology | 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110-1003 | 2020-06-26 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.