Individual
ADITYA KRISHNA SURESH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3660 VISTA AVE, SAINT LOUIS, MO 63110-2540
(314) 977-6100
(314) 977-6164
Mailing address
1402 S GRAND BLVD, SAINT LOUIS, MO 63104-1004
(314) 577-8762
(314) 268-5108
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036165452
IL
207R00000X
Internal Medicine Physician
2022030333
MO
208M00000X
Hospitalist Physician
Primary
2022030333
MO
Other
Enumeration date
03/20/2019
Last updated
06/10/2025
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