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Individual

NARSINGAM GATLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1034 S BRENTWOOD BLVD, SUITE 280, SAINT LOUIS, MO 63117-1223
(314) 727-0012
(314) 727-0014
Mailing address
2344 HAMPTON AVE, SAINT LOUIS, MO 63139-2909
(314) 647-2344
(314) 647-5108

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
R6379
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036054290
IL
01
194361
BLUE CROSS BLUE SHIELD
MO
05
207359902
MO
01
27716
GROUP HEALTH PLAN
MO
01
3848
CMR
MO
Enumeration date
07/10/2006
Last updated
05/19/2008
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