Individual
SENTHIL KRISHNASAMY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
621 S NEW BALLAS RD, SUITE 5006B, SAINT LOUIS, MO 63141-8232
(314) 432-5478
(314) 569-0864
Mailing address
12990 MANCHESTER RD, STE 201, DES PERES, MO 63131-1860
(314) 432-5478
(314) 569-0864
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
036105571
IL
207W00000X
Ophthalmology Physician
Primary
2008003783
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548250202
—
MO
Enumeration date
10/25/2005
Last updated
10/25/2018
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