Individual
DR. MIGUEL ANGEL PANIAGUA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D./M.P.H.
Contact information
Practice address
12414 LUSHER RD, SAINT LOUIS, MO 63138-1456
(314) 741-2500
(314) 741-0880
Mailing address
1532 FOUNTAINHEAD LN, SAINT LOUIS, MO 63138-3339
(314) 355-3873
(314) 355-7383
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036046269
IL
207RC0000X
Cardiovascular Disease Physician
R4B44
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
125391
PHCS
MO
01
—
192033
BCBSMO
MO
01
—
370983349
PANIAGUA MEDICAL LTD
MO
01
—
5709126
AETNA
MO
01
—
D04066
EXCLUSIVE CHOICE
MO
Enumeration date
10/18/2006
Last updated
08/12/2011
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