Individual
DEEPIKA BHATLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
1465 S GRAND BLVD, ST. LOUIS, MO 63104-1003
(314) 268-4000
(314) 268-4081
Mailing address
1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
(314) 577-5638
(314) 268-4081
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
107915
MO
208000000X
Pediatrics Physician
2007004394
MO
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
2007004394
MO
Other
Enumeration date
04/20/2007
Last updated
03/25/2021
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