Individual
ESAT I MEMISOGLU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3635 VISTA, ST LOUIS, MO 63110
(314) 268-5783
(314) 268-5116
Mailing address
3691 RUTGER AVE, PROVIDER ENROLLMENT, ST LOUIS, MO 63110
(314) 977-4440
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
2001007775
MO
2085R0202X
Diagnostic Radiology Physician
2001007775
MO
2085U0001X
Diagnostic Ultrasound Physician
2001007775
MO
Other
Enumeration date
07/20/2006
Last updated
01/09/2008
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