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NPI Code Detail

MEDICARE: DR. AVRIL SLAVIN M.D.

MEDICARE: DR. AVRIL SLAVIN 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
1207U00000XNuclear Medicine Physician108719MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1487617411
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AVRIL SLAVIN M.D.
Provider Business Mailing Address
First Line : 6420 CLAYTON RD
Second Line : ST. MARY'S HEALTH CENTER
City : SAINT LOUIS
State : MO
Zip : 63117-1811
Country : US
Telephone Number : 314-768-8276
Fax Number :
Provider Business Practice Location Address
First Line : 6420 CLAYTON RD
Second Line : ST. MARY'S HEALTH CENTER
City : SAINT LOUIS
State : MO
Zip : 63117-1811
Country : US
Telephone Number : 314-768-8276
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2006
Last Update Date : 07/13/2007

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