Individual
DR. JUAN CARLOS PARODI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4921 PARKVIEW PL, SUITE 8A, SAINT LOUIS, MO 63110-1032
(314) 362-6460
(314) 747-4871
Mailing address
PO BOX 8221, 7425 FORSYTH, SAINT LOUIS, MO 63156-8221
(314) 935-0770
(314) 935-0575
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
2003016659
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180684
MO-BLUE SHIELD
—
Enumeration date
07/18/2006
Last updated
07/08/2007
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