Individual
PRIYANKA RAVI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD,FRCPC
Contact information
Practice address
1402 S GRAND BLVD, SAINT LOUIS, MO 63104-1004
(314) 417-9510
Mailing address
1716 KENMONT RD, SAINT LOUIS, MO 63124-1022
(314) 417-9510
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
2023012592
MO
Other
Enumeration date
10/12/2023
Last updated
10/12/2023
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