Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 2005025947 | MO |
N | 111NI0900X | Internist | 2005025947 | MO |
N | 207RC0000X | Internist - Cardiovascular Disease | 2005025947 | MO |
Y | 207RI0011X | Interventional Cardiology | 2005025947 | MO |
NPI | 1124164066 |
---|---|
Provider Name | Dr. Sandeep Hindupur |
First Address | Saint Peters, MO 63376-1659 |
Second Address | Saint Peters, MO 63376-1659 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2007 |
Last Update Date | 26/02/2021 |