Individual
DR. THULASI RAM GOGIREDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 MEDICAL PLZ, LAKE ST LOUIS, MO 63367-1366
(636) 625-5200
Mailing address
100 MEDICAL PLZ, LAKE ST LOUIS, MO 63367-1366
(636) 625-5200
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2016011907
MO
Other
Enumeration date
06/22/2012
Last updated
10/15/2018
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