Organization
PD NEPHROLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NABIL TAUK M.D. (MEDICAL DIRECTOR)
(314) 543-5235
Entity
Organization
Contact information
Practice address
10004 KENNERLY RD, SUITE 103A, SAINT LOUIS, MO 63128-2173
(314) 543-5235
(314) 543-5216
Mailing address
10004 KENNERLY RD, SUITE 103A, SAINT LOUIS, MO 63128-2173
(314) 543-5235
(314) 543-5216
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
LC0921675
MO
Other
Enumeration date
10/03/2008
Last updated
02/24/2009
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