Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 01070696A | IN |
N | 207RC0000X | Internist - Cardiovascular Disease | 2010015033 | MO |
N | 207RI0011X | Interventional Cardiology | 036138092 | IL |
N | 207RI0011X | Interventional Cardiology | 2010015033 | MO |
NPI | 1023218807 |
---|---|
Provider Name | Dr. Rita Mukerji |
First Address | Saint Louis, MO 63141-8573 |
Second Address | Florissant, MO 63031 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2007 |
Last Update Date | 15/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
201056370 | (05) | IN |