Individual
PHILIP VAIDYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1201 S GRAND BLVD, SAINT LOUIS, MO 63104-1016
(314) 977-5060
(314) 977-1664
Mailing address
DIVISION OF GENERAL INTERNAL MEDICINE, ROOM 2717, 1008 SOUTH SPRING, SAINT LOUIS, MO 63110
(314) 977-5060
(314) 977-1664
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2005017816
MO
208M00000X
Hospitalist Physician
Primary
2005017816
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669445508
—
MO
Enumeration date
02/10/2006
Last updated
09/14/2025
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