EDWARD STEPHEN BOLESTA


Address: 1402 S Grand, St Louis, MO 63104
Phone: 3145778000

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).

Provider Overview

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

Taxonomy

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

Office Location

Street Address 1402 S GRAND
City ST LOUIS
State MO
Zip Code 63104

Providers in the same location

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

Providers in the same zip code

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 Information

Taxonomy Code 207ZP0101X
Grouping Allopathic & Osteopathic Physicians
Classification Pathology
Specialization Anatomic Pathology

Taxonomy Definition

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.

Providers in the same taxonomy and city

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

Providers in the same taxonomy and state

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
Find all providers with the same taxonomy

Competitor

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City ST LOUIS
Zip Code 63104

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Dataset Information

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.

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