Organization
MYSOREKAR SURGICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAJEEV NAGARAJ MYSOREKAR M.D. (MANAGER)
(314) 359-5648
Entity
Organization
Contact information
Practice address
8342 DELCREST DR, APT 303, SAINT LOUIS, MO 63124-2100
(314) 359-5648
Mailing address
8342 DELCREST DR, APT 303, SAINT LOUIS, MO 63124-2100
(314) 359-5648
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
108329
MO
Other
Enumeration date
02/27/2014
Last updated
04/22/2014
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