Individual
DR. NICHOLAS WILLIAM DEKORVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD PHD
Contact information
Practice address
1 CHILDRENS PL, DIV NEUROLOGY PEDIATRICS, STE 2130, SAINT LOUIS, MO 63110-1002
(314) 454-6120
(314) 454-4225
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 454-6120
(314) 454-4225
Taxonomy
Speciality
Code
Description
License number
State
2084E0001X
Epilepsy Physician
Primary
2024007984
MO
2084N0400X
Neurology Physician
2024007984
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200071949
—
MO
Enumeration date
06/18/2019
Last updated
07/17/2025
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