Individual
KANAYO TATSUMI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
1300 CLARK AVE, SAINT LOUIS, MO 63103-2718
(314) 622-4971
(314) 977-7615
Mailing address
1300 CLARK AVE, SAINT LOUIS, MO 63103-2718
(314) 622-4971
Taxonomy
Speciality
Code
Description
License number
State
207ZF0201X
Forensic Pathology Physician
Primary
2019024496
MO
207ZF0201X
Forensic Pathology Physician
278417
NY
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
2019024496
MO
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
278417
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/21/2011
Last updated
02/17/2021
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