Individual
PENINNAH MUTUNGI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10010 KENNERLY RD, 3 SOUTHBRIDGE, SAINT LOUIS, MO 63128-2106
(314) 525-1328
(314) 525-1378
Mailing address
10010 KENNERLY RD, SAINT LOUIS, MO 63128-2106
(314) 525-1328
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2010005859
MO
2083B0002X
Obesity Medicine (Preventive Medicine) Physician
2010005859
MO
208M00000X
Hospitalist Physician
036-120171
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036120171
—
IL
01
—
MA3704019
MEDICARE PTAN
MO
Enumeration date
04/09/2008
Last updated
02/24/2025
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