Organization
NOVA MEDICAL CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARA K VIDAN (ADMINISTRATOR)
(636) 795-1144
Entity
Organization
Contact information
Practice address
2230 S BRENTWOOD BLVD, SAINT LOUIS, MO 63144-1831
(314) 678-9355
(314) 721-9559
Mailing address
2230 S BRENTWOOD BLVD, SAINT LOUIS, MO 63144-1831
(314) 678-9355
(314) 721-9559
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
10/30/2019
Last updated
10/30/2019
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