Individual
ATHMARAM SHETTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7345 WATSON RD, SAINT LOUIS, MO 63119-4405
(314) 752-7100
(314) 752-3284
Mailing address
7345 WATSON RD, SAINT LOUIS, MO 63119-4405
(314) 752-7100
(314) 752-3284
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
104222
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209776806
—
MO
Enumeration date
09/07/2005
Last updated
03/14/2017
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