Provider Demographics
NPI:1932171220
Name:PAVLOPOULOS, TRICIA V (MD)
Entity Type:Individual
Prefix:
First Name:TRICIA
Middle Name:V
Last Name:PAVLOPOULOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 411607
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-3607
Mailing Address - Country:US
Mailing Address - Phone:314-432-1047
Mailing Address - Fax:314-569-6162
Practice Address - Street 1:3009 N BALLAS RD STE 142
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-2322
Practice Address - Country:US
Practice Address - Phone:314-924-3924
Practice Address - Fax:314-548-2255
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2023-03-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO106145207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H44370Medicare UPIN