Organization
NEUROMAR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIA M ZEVALLOS M.D. (OWNER)
(636) 931-6090
Entity
Organization
Contact information
Practice address
166 INDUSTRIAL DR., FESTUS, MO 63028
(636) 931-6090
(636) 933-9509
Mailing address
166 INDUSTRIAL DR., FESTUS, MO 63028
(636) 931-6090
(636) 933-9509
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
2000160887
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
504599309
—
MO
01
—
DF9044
RAILROAD MEDICARE PIN
MO
Enumeration date
05/14/2007
Last updated
06/10/2008
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