Individual
DR. SHILPA BODHANAMPATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
300 1ST CAPITOL DR, SAINT CHARLES, MO 63301-2844
(314) 317-0600
(314) 317-0606
Mailing address
12101 WOODCREST EXECUTIVE DR, SUITE 210, SAINT LOUIS, MO 63141-5047
(314) 317-0600
(314) 317-0606
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2010024505
MO
208M00000X
Hospitalist Physician
2010024505
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982860888
—
MO
Enumeration date
07/31/2008
Last updated
04/22/2014
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