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Organization

PAUL SELVADURAI INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. DARLENE BYRD (OFFICE MANAGER)
(314) 647-5300
Entity
Organization

Contact information

Practice address
6651 CHIPPEWA ST, SUITE 214, SAINT LOUIS, MO 63109-2538
(314) 647-5300
(314) 647-1996
Mailing address
6651 CHIPPEWA ST, SUITE 214, SAINT LOUIS, MO 63109-2538
(314) 647-5300
(314) 647-1996

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A59661504
ZZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200352607
MO
Enumeration date
09/15/2010
Last updated
09/21/2010
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