Organization
GYNECOLOGIC & RECONSTRUCTIVE SURGERY, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIONYSIOS K VERONIKIS MD (OWNER)
(314) 251-6753
Entity
Organization
Contact information
Practice address
621 S NEW BALLAS RD, SUITE 2002 B, SAINT LOUIS, MO 63141-8232
(314) 251-6753
(314) 251-4492
Mailing address
621 S NEW BALLAS RD, SUITE 2002 B, SAINT LOUIS, MO 63141-8232
(314) 251-6753
(314) 251-4492
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
112659
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4319760
ECFMG
—
Enumeration date
02/28/2007
Last updated
09/30/2011
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