Vidal T Sheen
Vascular Surgeon
11144 Tesson Ferry Rd Suite 100
Saint Louis
, Missouri 63123-6965
Vidal T Sheen
Vascular Surgeon
11144 Tesson Ferry Rd Suite 100
Saint Louis
, Missouri 63123-6965
(314) 842-1402
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About
Features
Specialties
- Vascular Surgeon
Languages spoken
- English
Location
First Address
- Vidal T Sheen
- 16974 Riverdale Dr
- Chesterfield, MO
- Zip : 63005-4474
- Fax : (314) 842-1402
- Phone : (314) 842-1441
Second Address
- Vidal T Sheen
- 11144 Tesson Ferry Rd Suite 100
- Saint Louis, MO
- Zip : 63123-6965
- Fax : (314) 842-1402
- Phone : (314) 842-1441
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2086S0129X | Vascular Surgeon | 108604 | MO |
National Provider Identifier
| NPI | 1083687859 |
|---|---|
| Provider Name | Vidal T Sheen |
| First Address | Chesterfield, MO 63005-4474 |
| Second Address | Saint Louis, MO 63123-6965 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 10/02/2006 |
| Last Update Date | 07/08/2015 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 203819214 | (05) | MO |
| 2665001 | MEDICARE PTAN (01) | MO |
| DT0542 | MEDICARE RAILROAD GROUP PTAN (01) | MO |
| G80151 | (02) | |
| P00695170 | MEDICARE RAILROAD (01) | MO |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.