Organization
NELLESTEIN VEIN INSTITUTE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL E. NELLESTEIN MD (PRESIDENT/OWNER)
(816) 291-4149
Entity
Organization
Contact information
Practice address
1341 VILLAGE DR, SAINT JOSEPH, MO 64506-2457
(816) 291-4149
(816) 897-3969
Mailing address
1341 VILLAGE DR, SAINT JOSEPH, MO 64506-2457
(816) 291-4149
(816) 897-3969
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
—
MO
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1841654423
—
MO
Enumeration date
04/08/2016
Last updated
01/17/2017
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