Individual
VIKTOR BALLADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10012 KENNERLY RD, STE 406, SAINT LOUIS, MO 63128-2197
(314) 525-1798
(314) 525-4469
Mailing address
10012 KENNERLY RD, STE 406, SAINT LOUIS, MO 63128-2197
(314) 525-1798
(314) 525-4469
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
016912
ME
207R00000X
Internal Medicine Physician
2013007023
MO
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
Primary
2013007023
MO
Other
Enumeration date
06/07/2006
Last updated
11/08/2017
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