Individual
DR. THILAK SREENIVASALU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3635 VISTA AVE, DESLOGE TOWERS, 3RD FLOOR, SAINT LOUIS, MO 63110-2539
(314) 268-7267
Mailing address
12400 BENNETT SPRINGS CT, APT B, SAINT LOUIS, MO 63146-3945
(216) 571-6270
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
2014022159
MO
Other
Enumeration date
04/03/2009
Last updated
08/06/2014
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