IndividualActive
Jose Derdoy, MD
NPI 1396838876 · Pediatric Gastroenterology Physician · Saint Louis, MO
Provider details
- NPI number
- 1396838876
- Entity type
- Individual
- Primary specialty
- Pediatric Gastroenterology PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 60035 (KY)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Other Service Providers
Practice location
615 S New Ballas Rd
Children'S Hospital, Ground Floor, Suite Yg220
Saint Louis, MO 63141-8221
Phone: (314) 251-5550
Fax: (314) 251-5552
Approximate (ZIP-level) locationGet directions
Mailing address
615 S New Ballas Rd
Saint Louis, MO 63141-8221
Additional practice locations (1)
- 231 E Chestnut StLouisville, KY 40202-1821Phone: (502) 588-2330Fax: (502) 588-9513
Registry dates
- Enumerated
- 2006-10-02
- Last updated
- 2024-10-04
- Certified
- 2024-10-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.