Individual
SHAUKAT A THANAWALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
97 SAINT ANDREWS DR, UNION, MO 63084-4546
(636) 583-2946
(636) 583-6131
Mailing address
901 PATIENTS FIRST DR, WASHINGTON, MO 63090-4700
(636) 239-7500
(636) 239-2836
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
105435
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208846949
—
MO
Enumeration date
06/10/2006
Last updated
01/23/2012
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