Organization
SRI D. KOLLI, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CYNTHIA JEAN WHITENER (OFFICE MANAGER)
(314) 525-4934
Entity
Organization
Contact information
Practice address
10004 KENNERLY RD, SUITE 330A, SAINT LOUIS, MO 63128-2141
(314) 525-4520
(314) 525-4521
Mailing address
10004 KENNERLY RD, SUITE 330A, SAINT LOUIS, MO 63128-2141
(314) 525-4520
(314) 525-4521
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
109530
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DA8462
RAILROAD MEDICARE
MO
Enumeration date
03/08/2007
Last updated
03/05/2008
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