Healthcare Provider Details

I. General information

NPI: 1609848852
Provider Name (Legal Business Name): VLADIMIR MILO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 06/25/2024
Certification Date: 06/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 BOWLES AVE
FENTON MO
63026-2394
US

IV. Provider business mailing address

PO BOX 504683
SAINT LOUIS MO
63150-0001
US

V. Phone/Fax

Practice location:
  • Phone: 636-496-2570
  • Fax: 636-333-4510
Mailing address:
  • Phone: 636-333-4500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number2003015147
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2003015147
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: