Individual
SANTHISRI KODALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6500 HOSPITAL DR, HANNIBAL, MO 63401-6890
(573) 629-3500
(573) 629-3314
Mailing address
6500 HOSPITAL DR, HANNIBAL, MO 63401-6890
(573) 629-3300
(573) 629-3314
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
BP10040647
TX
207RC0000X
Cardiovascular Disease Physician
2023025438
MO
207RC0000X
Cardiovascular Disease Physician
S4010
TX
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
2023025438
MO
207RC0001X
Clinical Cardiac Electrophysiology Physician
S4010
TX
Other
Enumeration date
05/23/2011
Last updated
07/18/2023
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