Organization
SANJAY GHOSH PHD MD PC
Active
Organization
SANJAY GHOSH PHD MD PC
Active
Other names
SANJAY GHOSH PHD MD PC
Organization subpart
No
Provider details
NPI number
Authorized official
SANJAY GHOSH (PHD MD PC)
(636) 390-2288
Entity
Organization
Contact information
Practice address
1080 CAROLINE DR, STE 200, WASHINGTON, MO 63090-4902
(636) 390-2288
(636) 390-2277
Mailing address
1080 CAROLINE DR, STE 200, WASHINGTON, MO 63090-4902
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
R6N94
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2636376
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
11/17/2006
Last updated
08/22/2020
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