Individual
DR. VENKATA R DEVINENI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12303 DE PAUL DR, DEPT. OF RADIATION ONCOLOGY, BRIDGETON, MO 63044-2512
(314) 344-6090
(314) 344-6093
Mailing address
2260 BARNBRIDGE RD, SAINT LOUIS, MO 63131-3130
(314) 344-6090
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
R9245
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
206831711
—
MO
Enumeration date
08/03/2006
Last updated
09/14/2011
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