Individual
KATEPALLE J MOORTHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10010 KENNERLY RD, SAINT LOUIS, MO 63128-2106
(314) 317-0600
(314) 317-0606
Mailing address
12101 WOODCREST EXECUTIVE DR, SUITE 210, SAINT LOUIS, MO 63141-5047
(314) 317-0600
(314) 317-0606
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036061972
IL
207R00000X
Internal Medicine Physician
Primary
36129
MO
208M00000X
Hospitalist Physician
036061972
IL
208M00000X
Hospitalist Physician
36129
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036061972
—
IL
05
—
201224060
—
MO
Enumeration date
02/10/2006
Last updated
02/13/2015
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