Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 103401 | MO |
NPI | 1063507531 |
---|---|
Provider Name | Rama Bandlamudi Atluri |
First Address | Saint Louis, MO 63104-1004 |
Second Address | Saint Louis, MO 63104-1016 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 15/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
205278310 | (05) | MO |
H42927 | (02) |