Provider Demographics
NPI:1548607229
Name:VASWANI, DEVIN (MD)
Entity Type:Individual
Prefix:DR
First Name:DEVIN
Middle Name:
Last Name:VASWANI
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 1:510 S KINGSHIGHWAY BLVD
Mailing Address - Street 2:CAMPUS BOX 8131
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1016
Mailing Address - Country:US
Mailing Address - Phone:314-362-2978
Mailing Address - Fax:314-747-4671
Practice Address - Street 1:510 S KINGSHIGHWAY BLVD
Practice Address - Street 2:CAMPUS BOX 8131
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1016
Practice Address - Country:US
Practice Address - Phone:314-362-2978
Practice Address - Fax:314-747-4671
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-04
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY292137-12085R0202X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty