Provider Demographics
NPI:1033162094
Name:HAVLIOGLU, NECAT (MD)
Entity Type:Individual
Prefix:
First Name:NECAT
Middle Name:
Last Name:HAVLIOGLU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3635 VISTA AVE
Mailing Address - Street 2:ST LOUIS UNIVERSITY HOSPITAL PATHOLOGY SERVICES
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-2539
Mailing Address - Country:US
Mailing Address - Phone:314-577-8475
Mailing Address - Fax:314-268-5478
Practice Address - Street 1:3635 VISTA AVE
Practice Address - Street 2:SAINT LOUIS UNIVERSITY PATHOLOGY SERVICES
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-2539
Practice Address - Country:US
Practice Address - Phone:314-577-8475
Practice Address - Fax:314-268-5478
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2011-10-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO101149207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOH47989Medicare UPIN