Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MT199388 | PA |
Y | 2080P0205X | Pediatric Endocrinologist | 2016041347 | MO |
N | 2080P0205X | Pediatric Endocrinologist | ME 118496 | FL |
NPI | 1073801874 |
---|---|
Provider Name | Soumya Kattikat |
First Address | Columbia, MO 65201 |
Second Address | Columbia, MO 65201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2011 |
Last Update Date | 16/08/2017 |