Individual
LOUIS V DEANE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
625 S NEW BALLAS RD, SUITE 2030, SAINT LOUIS, MO 63141-8253
(314) 251-1700
(314) 251-1700
Mailing address
625 S NEW BALLAS RD, SUITE 2030, SAINT LOUIS, MO 63141-8253
(314) 251-1700
(314) 251-1701
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
R4B28
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1144212630
—
MO
01
—
2543303
BNDD
MO
01
—
P00635256
RAILROAD MEDICARE
MO
01
—
R4B28
LICENSE
MO
Enumeration date
08/19/2005
Last updated
08/19/2014
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