Organization · Type 2 NPI

ST Louis University

Diagnostic Radiology Physician · St. Louis, MO

NPI number 1104899459 Active

Practice location

1225 S Grand Blvd
St. Louis, MO 63104-1016

Call (314) 257-2170 Map

Mailing address

3545 Lindell Blvd Fl 3
St. Louis, MO 63103-1020

Other practice locations

3635 Vista Ave, St. Louis, MO 63110-2539 · (314) 977-6828

Specialties and licenses

Taxonomy	Code	License
Body Imaging Physician	2085B0100X	None listed
Neuroradiology Physician	2085N0700X	None listed
Diagnostic Radiology Physician Primary	2085R0202X	None listed
Vascular & Interventional Radiology Physician	2085R0204X	None listed

Diagnostic Radiology Physician: A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

96 other providers at this address

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NPI record

NPI: 1104899459
Entity type: Organization (Type 2)
Issued: Feb 8, 2006
Last updated: Sep 21, 2021
Status: Active

Other names

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Slucare Department of Radiology · doing business as
Slucare Department of Radiology · doing business as

Authorized official

Mrs. Alyce Lanxon
Executive Director
(314) 977-6828

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1104899459

ST Louis University's National Provider Identifier is 1104899459, issued on Feb 8, 2006. The primary taxonomy on file is Diagnostic Radiology Physician (2085R0202X), and the practice location is in St. Louis, MO. The record was last updated on Sep 21, 2021.