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NPI Code Detail

MEDICARE: ULADZISLAU NAIDZIONAK M.D.

MEDICARE: ULADZISLAU NAIDZIONAK M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician2009012274MO

General Provider Information

NPI Number : 1023246212
Entity Type Code : Individual
Provider Name (Legal Business Name) : ULADZISLAU NAIDZIONAK M.D.
Provider Business Mailing Address
First Line : 8166 WHITBURN DR APT 5
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63105-2449
Country : US
Telephone Number : 808-237-0572
Fax Number :
Provider Business Practice Location Address
First Line : 6420 CLAYTON RD
Second Line : ST MARY'S HEALTH CENTER/DEPT OF INTERNAL MEDICINE
City : SAINT LOUIS
State : MO
Zip : 63117-1811
Country : US
Telephone Number : 314-768-8778
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2009
Last Update Date : 06/25/2009

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