Individual
GONGUNTLA V NAIDU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5535 DELMAR BLVD, SAINT LOUIS, MO 63112-3005
(314) 879-6363
Mailing address
5535 DELMAR BLVD, SAINT LOUIS, MO 63112-3005
(314) 879-6363
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
R6200
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200180008
—
MO
Enumeration date
05/15/2006
Last updated
03/28/2012
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