| Vvasudevan LLC | |
|
5401 Veterans Memorial Pkwy Ste 200 Saint Peters MO 63376-1687 | |
| (636) 206-6022 | |
| (780) 328-3971 |
| Full Name | Vvasudevan LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 5401 Veterans Memorial Pkwy Ste 200, Saint Peters, Missouri |
| Authorized Official Name and Position | Vijaya N Vasudevan (OWNER/PHYSICIAN) |
| Authorized Official Contact | 6362066022 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vvasudevan LLC Po Box 173 Saint Charles MO 63302-0173 Ph: (314) 952-8009 | Vvasudevan LLC 5401 Veterans Memorial Pkwy Ste 200 Saint Peters MO 63376-1687 Ph: (636) 206-6022 |
| NPI Number | 1659869857 |
|---|---|
| Provider Enumeration Date | 04/24/2018 |
| Last Update Date | 04/07/2022 |
| Certification Date | 04/07/2022 |
| Medicare PECOS PAC ID | 2567718992 |
|---|---|
| Medicare Enrollment ID | O20180627001970 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659869857 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | () | Primary |
| Provider Name | Vijaya Vasudevan |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1265634513 PECOS PAC ID: 9032351143 Enrollment ID: I20130819000830 |
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