Villalona, Gustavo Adolfo
Villalona, Gustavo Adolfo is an sole proprietor health care provider with primary practice located at 1465 S Grand Blvd , Saint Louis MO 63104-1003. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Surgery, which is considered as his primary health care specialty. Villalona, Gustavo Adolfo can be contacted via phone (314) 577-5629.Contact Information
Primary practice address
1465 S Grand Blvd
Saint Louis MO 63104-1003
Phone: (314) 577-5629
Fax: (314) 268-6454
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Surgery | 2086S0120X | 2015015962 | Missouri |
Profile Details
| NPI number | 1740447200 |
|---|---|
| LBN Legal business name | Villalona, Gustavo Adolfo |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 21st, 2008 |
| Last updated | Nov 27th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1740447200 | NPPES |
| Missouri | Other | 2015015962 | MISSOURI LICENSE |
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