Gourtzelis, Nicholas

Gourtzelis, Nicholas is an individual health care provider with primary practice located at 10004 Kennerly Rd Ste 374B, St Louis MO 63128. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Gourtzelis, Nicholas can be contacted via phone (314) 842-9669.

Contact Information

Primary practice address
10004 Kennerly Rd Ste 374B St Louis MO 63128
Phone: (314) 842-9669
Fax: (314) 842-1017
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 2005006931 Missouri

Profile Details

NPI number 1790734994
LBN Legal business name Gourtzelis, Nicholas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 8th, 2006
Last updated Jan 22nd, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790734994 NPPES
Missouri MEDICAID 207376708

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