Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Revere Anesthesiology LLC

Organization Anesthesiology Physician · NPI 1912137712

Revere Anesthesiology LLC is an Anesthesiology Physician in Festus, Missouri. Licensed in Missouri. Registered with an NPI since 2009.

Licensed in
MO
In the registry since
2009
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1101 W Gannon Dr
Festus, MO 63028-2602
Phone: (636) 931-5997
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X · Licence R6445 (MO)

Record details

NPI number1912137712
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Rodolfo Maceren — President · (636) 933-6569
NPI enumeratedJuly 15, 2009
Last updated in NPPESJuly 15, 2009
Mailing address2 Howe Xing, Festus, MO 63028-4044

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