Provider Demographics
NPI:1093878258
Name:JAVDAN, RON (MD)
Entity Type:Individual
Prefix:DR
First Name:RON
Middle Name:
Last Name:JAVDAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6 JUNGERMANN CIR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-1621
Mailing Address - Country:US
Mailing Address - Phone:636-928-1822
Mailing Address - Fax:636-441-7033
Practice Address - Street 1:6 JUNGERMANN CIR
Practice Address - Street 2:SUITE 203
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-1621
Practice Address - Country:US
Practice Address - Phone:636-928-1822
Practice Address - Fax:636-441-7033
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MOR8435207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease