Individual
DR. SUMANTH GANDRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
620 S TAYLOR AVE, DIV IM INFECTIOUS DISEASE, STE 100, SAINT LOUIS, MO 63110-1035
(314) 362-9098
(314) 362-9851
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 362-9098
(314) 362-9851
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
2018043760
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200066216
—
MO
Enumeration date
02/12/2008
Last updated
04/17/2025
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