Individual
SANJEEV B N RAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
909 N 14TH ST, SAINT LOUIS, MO 63106-3826
(314) 531-1770
(314) 771-9485
Mailing address
5701 DELMAR BLVD, SAINT LOUIS, MO 63112-2617
(314) 531-1770
(314) 771-9485
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
2005028681
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0-612-668-4
ECFMG
—
05
—
207610908
—
MO
Enumeration date
09/16/2006
Last updated
02/28/2017
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