Individual
DR. SUMAN VADDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1011 BOWLES AVE STE 300, FENTON, MO 63026-2387
(636) 496-5030
Mailing address
PO BOX 955534, SAINT LOUIS, MO 63195-2551
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2013017668
MO
207R00000X
Internal Medicine Physician
2018003024
MO
207RP1001X
Pulmonary Disease Physician
Primary
2018003024
MO
208M00000X
Hospitalist Physician
2018003024
MO
Other
Enumeration date
06/27/2013
Last updated
10/27/2020
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