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General NPI Number Information
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NPI Number | 1881690931
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Entity Type | Individual
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Provider Name | SEIICHI NODA MD
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Gender | Male
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Dates
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Enumeration Date | 06/23/2005
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Last Update Date | 06/21/2021
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Provider Practice Location Address
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Address Line | 10012 KENNERLY RD SUITE 403
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City | SAINT LOUIS
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State | MO
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Zip | 63128-2197
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Country | US
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Telephone | 314-880-6676
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Fax | 314-842-4372
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Provider Business Mailing Address
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Address Line | 3300 S FISKE BLVD
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City | ROCKLEDGE
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State | FL
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Zip | 32955-4306
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Country | US
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Telephone | 321-434-3455
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Fax | 321-434-3456
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | ME150578
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 200146129
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License Number State | MO
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