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NPI Profile for MODERN VASCULAR OF ST LOUIS LLC in CREVE COEUR, MO.
A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Vascular & Interventional Radiology |
2085R0204X | 94 | Physician/Interventional Radiology | |
Vascular-Interventional Technology Radiologic Technologist |
2471V0106X |
| NPI # | 1972106391 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 11/18/2020 | |
| Last updated | 11/18/2020 - About 6 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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MODERN VASCULAR OF ST LOUIS LLC
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| ST LUKES CENTER FOR DIAGNOSTIC IMAGING LLC 450 NORTH BALLAS ROAD SAINT LOUIS, MO |
| HUMBERTO M FAGUNDES, MD 3015 N NEW BALLAS RD SAINT LOUIS, MO |
| JOHN H NIEMEYER, MD 3015 N NEW BALLAS RD SAINT LOUIS, MO |
| CLELLAND J CHATMAN, MD 12303 DE PAUL DR BRIDGETON, MO |
| ADAM W TAVES, MD 300 FIRST CAPITOL DRIVE SAINT CHARLES, MO |
| GUNVIR S GILL, MD 300 FIRST CAPITOL DRIVE SAINT CHARLES, MO |
| JONATHAN D ROOT, MD 300 FIRST CAPITOL DRIVE SAINT CHARLES, MO |
| XAVIER A ROBINSON, MD 300 FIRST CAPITOL DRIVE SAINT CHARLES, MO |
| BRUCE J WALZ, MD 3635 VISTA SAINT LOUIS, MO |
| USTUN AYDINGOZ, MD 3635 VISTA SAINT LOUIS, MO |
MODERN VASCULAR OF ST LOUIS LLC