Provider Demographics
NPI:1952376170
Name:ALBOVIAS, JAY WELCH (MD)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:WELCH
Last Name:ALBOVIAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 417668
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-7668
Mailing Address - Country:US
Mailing Address - Phone:610-644-8900
Mailing Address - Fax:484-924-0053
Practice Address - Street 1:201 DUNN RD
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63031-7928
Practice Address - Country:US
Practice Address - Phone:314-830-3841
Practice Address - Fax:314-831-0153
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20010085282085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO206013807Medicaid
MOP00061168OtherRAILROAD MEDICARE
MO013010568Medicare ID - Type Unspecified
MO206013807Medicaid