Individual
DR. NICANOR D DEVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6150 OAKLAND AVE, CO MARILYN KORNBERGER, SAINT LOUIS, MO 63139-3215
(314) 768-3090
(314) 768-3031
Mailing address
531 PEBBLE BROOK LN, HMAI, BELLEVILLE, IL 62221-7609
(618) 779-5508
(618) 206-8588
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
R8B11
MO
Other
Enumeration date
03/26/2007
Last updated
07/08/2007
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