MODERN VASCULAR OF ST LOUIS LLC NPI 1972106391

NPI Information

NPI: 1972106391
Provider Name: MODERN VASCULAR OF ST LOUIS LLC
Classification: Radiology - 2085R0204X
Entity Type: Organization

Specialization: Vascular & Interventional Radiology

Address:
641 N NEW BALLAS RD
CREVE COEUR, MO
ZIP 63141
Phone: (314) 648-0101
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MODERN VASCULAR OF ST LOUIS LLC is a vascular and interventional radiology radiology in Creve Coeur, MO. The provider is a radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. MODERN VASCULAR OF ST LOUIS LLC NPI is 1972106391. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

641 N NEW BALLAS RD
CREVE COEUR, MO
ZIP 63141-713
Phone: (314) 648-0101
Fax: (314) 899-2715

The provider's authorized official is Yury Gampel .
The authorized official title is Ceo and has the following contact phone number (818) 880-8605.

The enumeration date for this NPI number is 11/18/2020 and was last updated on 11/18/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085R0204X	Radiology	Vascular & Interventional Radiology			Yes
2	2471V0106X	Radiologic Technologist	Vascular-Interventional Technology			No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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