Individual
DR. SUBBARAO POLINENI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6 JUNGERMAN CIR, STE 107, ST PETERS, MO 63376
(636) 928-1696
(636) 928-3115
Mailing address
6 JUNGERMAN CIR, STE 107, ST PETERS, MO 63376
(636) 928-1696
(636) 928-3115
Taxonomy
Speciality
Code
Description
License number
State
2086S0105X
Surgery of the Hand (Surgery) Physician
Primary
R7957
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201653805
—
MO
Enumeration date
11/04/2005
Last updated
11/21/2007
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