Individual
TATTAMANGALAM CHANDRIKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4055 LINDELL BLVD, SAINT LOUIS, MO 63108-3201
(314) 535-7701
Mailing address
4055 LINDELL BLVD, SAINT LOUIS, MO 63108-3201
(314) 535-7701
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
R6G03
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100193
HEALTHLINK
MO
01
—
1200160
UHC
MO
01
—
1818V343411
HEALTHCARE USA
MO
01
—
28790
BCBS
MO
01
—
40291
GHP
MO
01
—
4038830
AETNA
MO
01
—
A29039
MERCY
MO
Enumeration date
11/03/2005
Last updated
10/03/2011
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