Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 112659 | MO |
NPI | 1629047626 |
---|---|
Provider Name | Dionysios K Veronikis |
First Address | Saint Louis, MO 63141-8232 |
Second Address | Saint Louis, MO 63141-8232 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 05/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
431-976-0 | ECFMG (01) | |
G22623 | (02) | MO |