Individual
SOFIA GREWAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2639 MIAMI ST, ST LOUIS, MO 63118
(314) 268-6195
(314) 268-6155
Mailing address
3535 S JEFFERSON, STE 314, ST LOUIS, MO 63118
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
106475
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204687511
—
MO
01
—
6032C1
BLUE CROSS
—
Enumeration date
08/07/2006
Last updated
07/08/2007
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