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VIDYARATNA A FLEETWOOD M.D. NPI 1649534231


NPI Information

NPI: 1649534231
Provider Name: VIDYARATNA A FLEETWOOD, M.D.
Classification: Transplant Surgery - 204F00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
1225 S GRAND BLVD FL 3
SAINT LOUIS, MO
ZIP 63104
Phone: (314) 257-3760
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Vidyaratna A Fleetwood, M.D. is a transplant surgery in Saint Louis, MO with 12 years of experience. The provider is a surgeon who specializes in transplant surgery. Source: National Uniform Claim Committee Vidyaratna A Fleetwood, M.D. NPI is 1649534231. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: MEDICAL UNIVERSITY OF SOUTH CAROLINA COLLEGE OF MEDICINE
Graduation Year:2012

The provider's business location address is:

1225 S GRAND BLVD FL 3
SAINT LOUIS, MO
ZIP 63104-016
Phone: (314) 257-3760
Fax: (314) 257-3761

The NPI 1649534231 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/27/2012 and was last updated on 3/23/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1204F00000XTransplant Surgery2020026557MISSOURIYes
2204F00000XTransplant Surgery69614WISCONSINNo
3208600000XSurgery69614WISCONSINNo
4208600000XSurgery125061738ILLINOISNo
5208600000XSurgery2020026557MISSOURINo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.