Dr. Genova, LLC
Internal Medicine in O Fallon, MO. Organization (NPI-2).
NPI number1699865576
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1699865576
- Entity type
- Organization (NPI-2)
- Legal business name
- Dr. Genova, LLC
- Organization subpart
- No
- Enumeration date
- Oct 13, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | R3C40 | MO | Yes |
Practice location
5551 Winghaven BlvdSuite 132
O Fallon, MO 63368-3617
Phone 636-695-2520 · Fax 636-695-2526
Mailing address
5551 Winghaven BlvdSuite 132
O Fallon, MO 63368-3617
Phone 636-695-2520 · Fax 636-695-2526
Authorized official
Gregory P Genova
Physician
6366952520
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