Individual
MR. ILIR POLOVINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
12345 W BEND DR STE 200, SAINT LOUIS, MO 63128-2253
(314) 843-8000
(314) 843-3004
Mailing address
12345 W BEND DR STE 200, SAINT LOUIS, MO 63128-2253
(314) 843-8000
(314) 843-3004
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2003005393
MO
Other
Enumeration date
02/16/2009
Last updated
02/16/2009
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