OrganizationActive
Infectious Disease, PC
NPI 1609065051 · Infectious Disease Physician · Saint Louis, MO
Provider details
- NPI number
- 1609065051
- Entity type
- Organization
- Primary specialty
- Infectious Disease PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Suresh Nellore, Authorize Official(314) 729-1570
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Registered Nurse163W00000X
Nursing Service Providers
- Acute Care Clinical Nurse Specialist364SA2100X
Physician Assistants & Advanced Practice Nursing Providers
Practice location
10004 Kennerly Rd
Suite 368b
Saint Louis, MO 63128-2141
Phone: (314) 729-1570
Fax: (314) 729-1575
Approximate (ZIP-level) locationGet directions
Mailing address
1836 Lackland Hill Pkwy
Saint Louis, MO 63146-3572
Registry dates
- Enumerated
- 2007-10-22
- Last updated
- 2008-02-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.