Individual
SUDHAKAR R VADDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3015 N BALLAS RD, SAINT LOUIS, MO 63131-2329
(314) 996-5000
Mailing address
3015 N BALLAS RD, SAINT LOUIS, MO 63131-2329
(314) 996-5000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
R2D01
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050016088
RAILROAD MEDICARE
MO
05
—
201857125
—
MO
Enumeration date
06/22/2005
Last updated
03/06/2024
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