Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 100572 | MO |
NPI | 1427035955 |
---|---|
Provider Name | Mr. Gurpreet Padda |
First Address | Saint Louis, MO 63109-2356 |
Second Address | Saint Louis, MO 63109-2356 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2005 |
Last Update Date | 18/02/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
118505 | GHP (01) | MO |
149848 | BLUE CROSS BLUE SHILED (01) | MO |
175746 | HELATH LINK (01) | MO |
2001272 | UHC (01) | MO |
4647144 | AETNA (01) | MO |
7200000096 | MEDICARE RAIL ROAD (01) | MO |