Individual
KISHORE MAGANTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
522 N NEW BALLAS RD STE 210, SAINT LOUIS, MO 63141-6829
(314) 328-5930
(314) 328-5933
Mailing address
522 N NEW BALLAS RD STE 210, SAINT LOUIS, MO 63141-6829
(314) 328-5930
(314) 328-5933
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
2013012523
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200005035
—
MO
Enumeration date
04/10/2007
Last updated
05/21/2024
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