Individual
DR. SHAILAJA PULISETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
12026 CONWAY RD, SAINT LOUIS, MO 63131-2417
(636) 566-8155
(636) 566-8732
Mailing address
12026 CONWAY RD, SAINT LOUIS, MO 63131-2417
(636) 566-8155
(636) 566-8732
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2005019644
MO
Other
Enumeration date
05/18/2007
Last updated
05/02/2014
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