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Organization
METRO HYPERTENSION & KIDNEY CENTER PC
Active
Organization
METRO HYPERTENSION & KIDNEY CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONOVAN C POLACK (MD)
(314) 432-2580
Entity
Organization
Contact information
Practice address
1400 US HIGHWAY 61 STE 240, FESTUS, MO 63028-4141
(636) 937-3337
(636) 931-7671
Mailing address
PO BOX 1449, MARYLAND HEIGHTS, MO 63043-0449
(314) 432-2580
(314) 432-0223
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
2000155017
MO
174400000X
Specialist
R5H69
MO
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC5238
RAILROAD MEDICARE
MO
Enumeration date
06/16/2006
Last updated
03/20/2018
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