Individual
VIACHESLAV IREMASHVILI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6500 HOSPITAL DR, HANNIBAL, MO 63401-6890
(573) 629-3500
(573) 629-3515
Mailing address
PO BOX 1239, HANNIBAL, MO 63401-1239
(573) 629-3500
(573) 629-3515
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
2021043051
MO
208800000X
Urology Physician
67519
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/04/2012
Last updated
01/19/2022
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