Provider Demographics
NPI:1962521609
Name:MENTZELOPOULOS, PARASKEVI (MD)
Entity type:Individual
Prefix:DR
First Name:PARASKEVI
Middle Name:
Last Name:MENTZELOPOULOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4910 W PINE BLVD
Mailing Address - Street 2:APT501
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108-1976
Mailing Address - Country:US
Mailing Address - Phone:203-675-7695
Mailing Address - Fax:314-362-7641
Practice Address - Street 1:660 S EUCLID AVE
Practice Address - Street 2:CMPS BOX 8127
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1010
Practice Address - Country:US
Practice Address - Phone:314-362-7617
Practice Address - Fax:314-362-7641
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2005022500207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2005022500OtherLICENSE NUMBER
MOBM9407897OtherDEA NUMBER