Organization
MADHURAM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAMLESH VYAS MD (OWNER)
(314) 881-0300
Entity
Organization
Contact information
Practice address
3915 WATSON RD STE 100, SAINT LOUIS, MO 63109-1251
(314) 881-0300
Mailing address
2168 WHITE LANE DR, CHESTERFIELD, MO 63017-7947
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
06/23/2021
Last updated
06/23/2021
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