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Individual

SRIPATT KULKAMTHORN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
8710 MANCHESTER RD, SAINT LOUIS, MO 63144-2724
(314) 961-3570
(314) 961-6450
Mailing address
PO BOX 1239, TROY, MI 48099-1239
(248) 824-6600
(248) 324-1477

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35018
MO
208600000X
Surgery Physician
35018
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0004000577
AETNA
MO
01
01003230
UNITED HEALTHCARE
MO
01
115186
HEALTHLINK
MO
05
201098019
MO
01
2365237
CIGNA
MO
01
327602073KUL
MERCY HEALTH PLAN
MO
01
32901
MISSOURI BC/BS
MO
01
3542
HEALTHCARE USA PROVIDER #
MO
01
431280201
AETNA
MO
01
45992
GROUP HEALTH PLAN
MO
01
A09758
CMR
MO
Enumeration date
09/03/2006
Last updated
12/07/2011
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