Individual
PRAVEENA UPPAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
11155 DUNN RD, STE 315E, SAINT LOUIS, MO 63136-6150
(314) 355-7500
(314) 355-3287
Mailing address
PO BOX 955534, SAINT LOUIS, MO 63195-5534
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
2006024933
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005871557
—
VA
01
—
277060
ANTHEM
VA
Enumeration date
08/23/2005
Last updated
10/27/2020
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