Individual
RENUKA E PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
(314) 577-5380
(314) 268-4141
Mailing address
1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
(314) 577-5633
(314) 268-4141
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
2009020687
MO
2080P0202X
Pediatric Cardiology Physician
A78953
CA
Other
Enumeration date
09/20/2006
Last updated
01/20/2021
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