# VASCULAR INSTITUTE AT DEPAUL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437254869
- **Authorized official:** JOSHUA S. GLASER M.D. (SURGEON)
- **Authorized official phone:** (314) 770-0991

## Contact information

- **Practice address:** 12266 DEPAUL DR., SUITE 315, BRIDGETON, MO 63044
- **Practice address phone:** (314) 770-0991
- **Practice address fax:** (314) 770-0692
- **Mailing address:** 12266 DEPAUL DR., SUITE 315, BRIDGETON, MO 63044
- **Mailing address phone:** (314) 770-0991
- **Mailing address fax:** (314) 770-0692

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | NULL | Yes |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/13/2006
- **Last updated:** 11/20/2007