Individual
SRIRAM MAITRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 JEFFERSON BARRACKS DR, BUILDING 53, SAINT LOUIS, MO 63125-4181
(314) 894-6408
Mailing address
1031 POLO DOWNS DR, CHESTERFIELD, MO 63017-8358
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036-103787
IL
207R00000X
Internal Medicine Physician
2011024860
MO
Other
Enumeration date
02/21/2006
Last updated
06/04/2024
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