Individual
SHARADA NAGOTU KAMBAGIRI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-2600
(417) 820-2100
Mailing address
PO BOX 505164, SAINT LOUIS, MO 63150-5164
(417) 829-4620
(417) 829-4316
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036126351
IL
207R00000X
Internal Medicine Physician
2014044152
MO
208M00000X
Hospitalist Physician
036126351
IL
208M00000X
Hospitalist Physician
Primary
2014044152
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629381611
—
MO
Enumeration date
07/19/2010
Last updated
05/08/2017
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