Individual
DR. SONGYOTH SAKDISRI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2001 STATE ST, EAST SAINT LOUIS, IL 62205-1803
(618) 271-9191
(618) 271-9617
Mailing address
2001 STATE ST, EAST SAINT LOUIS, IL 62205-1803
(618) 271-9191
(618) 271-9617
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036148571
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036048571
—
IL
Enumeration date
09/07/2006
Last updated
09/02/2011
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