Individual
VIDAL T SHEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11144 TESSON FERRY RD, SUITE 100, SAINT LOUIS, MO 63123-6965
(314) 842-1441
(314) 842-1402
Mailing address
11144 TESSON FERRY RD STE 100, SAINT LOUIS, MO 63123-6965
(314) 842-1441
(877) 327-5055
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
2020018872
MO
2086S0129X
Vascular Surgery Physician
Primary
2020018872
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2020018872
MO MEDICAL LICENSE
MO
Enumeration date
02/10/2006
Last updated
09/16/2024
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