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Individual

KESHAV SHIVRAM JOSHI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
12855 N 40 DR, SUITE 275, SAINT LOUIS, MO 63141-8657
(314) 469-6200
(314) 469-6206
Mailing address
1207 MAPLE ST, FARMINGTON, MO 63640-7616
(573) 756-3000
(573) 756-3002

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
R4B81
MO
208VP0000X
Pain Medicine Physician
R4B81
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MA1140005
MEDICARE PTAN
MO
Enumeration date
04/05/2006
Last updated
05/28/2009
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