DR. VENKATA KR BODAVULA (NPI# 1275714784) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1275714784 |
Entity Type | Individual |
Full Name | DR. VENKATA KR BODAVULA |
Credential | MD |
Practice Address |
5600 Mexico Rd Ste 21 Saint Peters MO 63376-1660 |
Mailing Address |
3394 Mckelvey Rd Ste 115 Bridgeton MO 63044-2531 |
Practice Telephone | 6363739882 |
Mailing Telephone | 6363739882 |
Mailing Fax Number | 8662833416 |
Enumeration Date | 2007-11-27 |
Last Update Date | 2018-03-17 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2086S0105X |
Surgery Specialization: Surgery of the Hand |
2010007564 | MO | Allopathic & Osteopathic Physicians |
Address | Telephone Number | Fax Number |
---|---|---|
6 Jungermann Cir, Suite107, Saint Peters, MO 633761621 | 6369281696 |
Street Address |
5600 MEXICO RD STE 21 |
City | SAINT PETERS |
State | MO |
Zip Code | 63376-1660 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1265634513 | Vijaya Nattuvetty Vasudevan | Internal Medicine | 5600 Mexico Rd Ste 21, Saint Peters, MO 63376-1660 | 2007-05-31 |
1659869857 | Vvasudevan LLC | Internal Medicine | 5600 Mexico Rd Ste 21, Saint Peters, MO 63376-1660 | 2018-04-24 |
1962675744 | Boonslick Pediatrics | Preferred Provider Organization | 5600 Mexico Rd Ste 21, Saint Peters, MO 63376-1660 | 2008-04-11 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275047946 | Nicholas Christian Schultz | Dentist | 100 Piper Hill Dr Ste A, Saint Peters, MO 63376 | 2017-11-16 |
1982120093 | Carol Weber | Speech-Language Pathologist | 166 Boone Hills Dr., St Peters, MO 63376 | 2017-08-21 |
1619424744 | Forefront Dermatology, S.c. | Dermatology | 5700 Mexico Rd, Suite 14, Saint Peters, MO 63376 | 2016-09-07 |
1508310632 | Preferred Family Healthcare, Inc. | Counselor | 2120 Parkway Dr, Saint Peters, MO 63376 | 2016-08-05 |
1598130676 | Delta Center Personal Attendant Services | In Home Supportive Care | 3833 Mcclay, Suite 61, St. Peters, MO 63376 | 2015-12-01 |
1427420314 | Barbara Marlene Edelman | Counselor | 1286 Jungerman Rd. Suite G, St. Peters, MO 63376 | 2015-10-30 |
1255740247 | Claire Williams | Dentist | 340 Mid Rivers Mall Drive, Suite E, St. Peters, MO 63376 | 2014-08-05 |
1184042855 | Keith Wickenhauser | Internal Medicine | 201 Bjc Saint Peters Dr Ste 100, Saint Peters, MO 63376 | 2014-03-31 |
1821415233 | Abby Link | Physician Assistant | 107 Piper Parkway, #150, St. Peters, MO 63376 | 2014-03-24 |
1225452105 | Ashley Gagel | Physical Therapist | 7055 Mexico Rd Suite 1601, St. Peters, MO 63376 | 2014-02-12 |
Find all providers in zip 63376 |
Taxonomy Code | 2086S0105X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Surgery |
Specialization | Surgery of the Hand |
A surgeon with expertise in the investigation, preservation and restoration by medical, surgical and rehabilitative means, of all structures of the upper extremity directly affecting the form and function of the hand and wrist. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740616705 | Andrew J. Kochevar, Md, Pllc | Surgery | 3306 Vista Ave, Saint Louis, MO 63104-1106 | 2013-09-23 |
1699766980 | Subbarao Polineni | Surgery | 6 Jungerman Cir, Ste 107, St Peters, MO 63376 | 2005-11-04 |
1235659061 | Colin William Mcinnes | Surgery | One Barnes Jewish Hospital Plaza, Saint Louis, MO 63110 | 2017-06-22 |
1154561538 | Jeffrey Mark Pike | Surgery | 4921 Parkview Pl, Ste 6a, Saint Louis, MO 63110-1032 | 2009-02-25 |
1801099841 | Surgery Specialist of St. Louis | Surgery | 1035 Bellevue Ave, Suite 203, Saint Louis, MO 63117-1854 | 2007-06-07 |
1447472519 | Midwest Special Surgery, P.C. | Surgery | 830 Waterbury Falls Dr, O Fallon, MO 63368-2215 | 2007-05-02 |
1497974075 | St Louis University | Surgery | 1755 S Grand Blvd, Saint Louis, MO 63104-1540 | 2007-04-24 |
1508997529 | Nicole S Schroeder | Surgery | 4921 Parkview Pl, Ste 6a, Saint Louis, MO 63110-1032 | 2007-03-08 |
1184779399 | Tony E Sudekum | Surgery | 830 Waterbury Falls Dr, O Fallon, MO 63368-2215 | 2007-01-25 |
1639192123 | Scott Alan Langford | Surgery | 120 Ne Saint Lukes Blvd Ste 200, Lees Summit, MO 64086-6011 | 2006-07-25 |
Find all providers with the same taxonomy |
City | SAINT PETERS |
Zip Code | 63376 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.