Individual
RUPA MAITRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4500 COLLEGE AVE, ALTON, IL 62002-5051
(618) 474-3800
Mailing address
64 YONDER HILL DR, CARBONDALE, IL 62903-8244
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
IL
Other
Enumeration date
08/19/2006
Last updated
07/08/2007
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