Individual
SURESH NELLORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10004 KENNERLY RD STE 295B, SAINT LOUIS, MO 63128-2177
(314) 740-2949
(314) 375-5020
Mailing address
10004 KENNERLY RD STE 295B, SAINT LOUIS, MO 63128-2177
(314) 740-2949
(314) 375-5022
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
108767
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208059923
—
MO
Enumeration date
03/01/2006
Last updated
04/16/2025
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