Individual
PRITYI RANI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
300 MEDICAL PLZ STE 221, LAKE ST LOUIS, MO 63367-1483
(636) 625-6041
Mailing address
PO BOX 955534, SAINT LOUIS, MO 63195-5534
(636) 498-5973
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
2011013993
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2011013993
MO TEMP LICENSE
MO
01
—
2015007982
MEDICAL LICENSE
MO
Enumeration date
08/01/2011
Last updated
11/16/2020
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