Provider Demographics
NPI:1376148387
Name:SLIVANY, NOZHDAR (PHARMD)
Entity type:Individual
Prefix:DR
First Name:NOZHDAR
Middle Name:
Last Name:SLIVANY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9031 BIG CHIEF DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63123-6605
Mailing Address - Country:US
Mailing Address - Phone:314-563-1160
Mailing Address - Fax:
Practice Address - Street 1:11253 SAINT CHARLES ROCK RD
Practice Address - Street 2:
Practice Address - City:BRIDGETON
Practice Address - State:MO
Practice Address - Zip Code:63044-2702
Practice Address - Country:US
Practice Address - Phone:314-738-0235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020020055183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist