Organization
CHOTCHAI SRISURO, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHOTCHAI SRISURO M.D. (PRESIDENT)
(314) 518-3665
Entity
Organization
Contact information
Practice address
1011 BOWLES AVE, SUITE G10, FENTON, MO 63026-2387
(636) 496-5450
(636) 496-4963
Mailing address
1011 BOWLES AVE, SUITE G10, FENTON, MO 63026-2387
(636) 496-5450
(636) 496-4963
Taxonomy
Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
Primary
33186
MO
Other
Enumeration date
06/10/2009
Last updated
06/10/2009
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