Individual
DR. SOMASEKHAR R BANDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
607 S NEW BALLAS RD, SUITE 3125, SAINT LOUIS, MO 63141-8222
(314) 353-1870
(314) 353-1984
Mailing address
607 S NEW BALLAS RD, SUITE 3125, SAINT LOUIS, MO 63141-8222
(314) 353-1870
(314) 353-1984
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
105454
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1922034321
—
MO
05
—
209796622
—
MO
01
—
43-1823174
TAX IDENTIFICATION NUMBER
MO
01
—
P00684805
RAILROAD MEDICARE
MO
Enumeration date
06/25/2006
Last updated
07/01/2014
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