Healthcare Provider Details
I. General information
NPI: 1326521899
Provider Name (Legal Business Name): VERONICA ANALIA GUERRA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/11/2018
Last Update Date: 06/30/2023
Certification Date: 06/30/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 BARNES JEW HOSP PLZ
SAINT LOUIS MO
63110-1003
US
IV. Provider business mailing address
660 S EUCLID AVE
SAINT LOUIS MO
63110-1010
US
V. Phone/Fax
- Phone: 314-273-4766
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | 2023023805 |
| License Number State | MO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: