Individual
SIVARAM PRABHUJI MUPPANENI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
SSM ST MARY'S HOSPITAL, 6420 CLAYTON ROAD, ST. LOUIS, MO 63117
(314) 768-8778
Mailing address
32-186, VASAVINAGAR, ADDANKI, PRAKASAM (DST), ANDHRA PRADESH 52320-1
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0444982
KS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/25/2018
Last updated
11/03/2022
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