Individual
PHAN SALIGRAMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD/PHD
Contact information
Practice address
15945 CLAYTON RD STE 120B, BALLWIN, MO 63011-2490
(636) 256-5070
(636) 256-5066
Mailing address
15945 CLAYTON RD STE 120B, BALLWIN, MO 63011-2490
(636) 256-5070
(636) 256-5066
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
R75476
AZ
207RR0500X
Rheumatology Physician
Primary
2024015235
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/07/2016
Last updated
10/28/2024
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