Provider Demographics
NPI:1568626752
Name:YONICK, DAVID VINCENT (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:VINCENT
Last Name:YONICK
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 1:701 S NEW BALLAS RD STE 310
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8725
Mailing Address - Country:US
Mailing Address - Phone:314-251-8750
Mailing Address - Fax:
Practice Address - Street 1:701 S NEW BALLAS RD STE 310
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8725
Practice Address - Country:US
Practice Address - Phone:314-251-8750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43011092462086S0122X, 2086S0122X
MO20230366852086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery