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Contact Information

JOSE J DERDOY, MD
615 S NEW BALLAS RD
CHILDREN'S HOSPITAL, GROUND FLOOR, SUITE YG220
SAINT LOUIS, MO63141-8221
 Phone: 314-251-5550
 Fax: 314-251-5552
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Gastroenterology

2080P0206X 37 Physician/Pediatric Medicine
 

Specialist

174400000X
Indicates primary specialty

NPI Profile & details for JOSE J DERDOY · (Male)

NPI Number 1396838876
Status Active
Credentials MD
Entity Individual
Enumeration date 10/02/2006
Last updated 10/04/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • KY License # 60035
  • MO License # 2007002166
  • MO License # 430654872
  • CA Medicaid 00A730200
  • IN Medicaid 300096168
  • MO Medicaid 1396838876
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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