Individual
SUNTHOSH PARVATHANENI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-3911
Mailing address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-3911
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
2012016500
MO
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
2012016500
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982814935
—
MO
01
—
BP1-0022914
INSTITUTIONAL PERMIT
—
Enumeration date
05/22/2007
Last updated
02/13/2020
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