Individual
MEGHASHYAM JAYATEERTH KOTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15740 S OUTER 40 RD # C, CHESTERFIELD, MO 63017-2004
(636) 735-4963
Mailing address
100 E LANCASTER AVE, WYNNEWOOD, PA 19096-3450
(610) 645-8560
(610) 645-3149
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2019011734
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
037276
MLHC MEDICARE AA #
PA
01
—
440771
MLHC AA #
PA
Enumeration date
09/22/2008
Last updated
12/13/2019
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