Organization
SUSEELA SAMUDRALA MD PC
Active
Other names
Metro Rehab Physicians
Organization subpart
No
Provider details
NPI number
Authorized official
MARINA MCROY (OFFICE MANAGER)
(314) 355-7880
Entity
Organization
Contact information
Practice address
11125 DUNN ROAD, SUITE 311, ST LOUIS, MO 63136
(314) 653-5730
(314) 355-8899
Mailing address
11125 DUNN ROAD, SUITE 311, ST LOUIS, MO 63136
(314) 653-5730
(314) 355-8899
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
R8290
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
507527000
—
MO
Enumeration date
04/13/2006
Last updated
04/12/2010
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