Individual
DR. MANOKIRAN PATRI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
330 1ST CAPITOL DR STE 260, SAINT CHARLES, MO 63301-2888
(636) 925-0900
(636) 925-0960
Mailing address
PO BOX 504934, SAINT LOUIS, MO 63150-4934
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
036-104049
IL
207RI0200X
Infectious Disease Physician
Primary
2009027341
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036-104049
MEDICAL LICENSE NUMBER
IL
Enumeration date
07/10/2006
Last updated
07/14/2021
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