Organization
ID CONSULTANTS, PC
Active
Organization
ID CONSULTANTS, PC
Active
Other names
DOMMARAJU, PC
Organization subpart
No
Provider details
NPI number
Authorized official
CHANDRA B DOMMARAJU MD (OWNER)
(636) 933-2344
Entity
Organization
Contact information
Practice address
1390 US HIGHWAY 61, SUITE G1500, FESTUS, MO 63028-4137
(636) 933-2344
Mailing address
PO BOX 29197, SAINT LOUIS, MO 63126-0197
(314) 432-2580
(314) 432-0223
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
MO106962
MO
Other
Enumeration date
07/04/2006
Last updated
08/22/2020
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