Individual
SRIRAJ T. KANUNGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6812 STATE ROUTE 162 STE 121, MARYVILLE, IL 62062-8586
(618) 391-5690
(618) 391-5691
Mailing address
6810 STATE ROUTE 162, BOX 215, MARYVILLE, IL 62062
(618) 391-6495
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
2005018762
MO
Other
Enumeration date
10/04/2006
Last updated
08/28/2024
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