Individual
INDUMATHI BASKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1241 W STADIUM BLVD, JEFFERSON CITY, MO 65109-6023
(573) 635-5264
(573) 761-4351
Mailing address
PO BOX 104240, JEFFERSON CITY, MO 65110-4240
(573) 635-5264
(573) 761-4351
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2006016360
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
215614
BCBS
MO
01
—
295310
GHP
MO
01
—
770152
HEALTHLINK
MO
01
—
CC7852
RAILROAD GROUP
MO
01
—
P00384937
MEDICARE RAILROAD
MO
Enumeration date
07/20/2006
Last updated
10/18/2007
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