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General NPI Number Information
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NPI Number | 1952288953
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Entity Type | Organization
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Legal Business Name | LUNETA RADIOLOGY LLC
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Dates
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Enumeration Date | 08/20/2025
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 604 SPYGLASS SUMMIT DR
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City | CHESTERFIELD
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State | MO
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Zip | 63017-2141
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Country | US
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Telephone | 314-420-9589
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Fax |
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Provider Business Mailing Address
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Address Line | 18336 EDISON AVE # 1044
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City | CHESTERFIELD
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State | MO
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Zip | 63005-3618
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CMO
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Name | MR. MICHAEL STADNYK
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Credential | MD
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Telephone | 314-420-9589
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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