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Individual

SHIV DALLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1 BARNES JEW HOSP PLZ, SAINT LOUIS, MO 63110-1003
(314) 362-2978
Mailing address
510 S KINGSHIGHWAY BLVD # 8131, SAINT LOUIS, MO 63110-1016
(314) 362-2978

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
94-11350
KS
2085R0202X
Diagnostic Radiology Physician
2024013682
MO
2085R0204X
Vascular & Interventional Radiology Physician
Primary
2024013682
MO

Other

Enumeration date
05/23/2023
Last updated
07/22/2024
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