Individual
DR. ABBE SUDVARG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
401 HOLLY HILLS AVE, SAINT LOUIS, MO 63111-2410
(314) 353-5190
(314) 353-1310
Mailing address
401 HOLLY HILLS AVE, SAINT LOUIS, MO 63111-2410
(314) 353-5190
(314) 353-1310
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R9F80
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
028010581
CPIN
MO
05
—
206991309
—
MO
05
—
206991317
—
MO
Enumeration date
12/02/2005
Last updated
12/02/2021
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