Individual
LUIS J ANGLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
701 S NEW BALLAS RD STE 330, SAINT LOUIS, MO 63141-8702
(314) 251-8850
(314) 569-3846
Mailing address
701 S NEW BALLAS RD STE 330, SAINT LOUIS, MO 63141-8702
(314) 251-8850
(314) 569-3846
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
R1P44
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00195679
PALMETTO RR MEDIARE
MO
Enumeration date
04/10/2006
Last updated
09/06/2023
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