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NPI Code Detail

MEDICARE: DR. SUDHIR R RAIKAR M.D.

MEDICARE: DR. SUDHIR R RAIKAR M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207PP0204XPediatric Emergency Medicine (Emergency Medicine) PhysicianR8500MO

General Provider Information

NPI Number : 1124013487
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SUDHIR R RAIKAR M.D.
Provider Business Mailing Address
First Line : 920 BELLERIVE MANOR DR
Second Line :
City : CREVE COEUR
State : MO
Zip : 63141-6094
Country : US
Telephone Number : 314-434-6841
Fax Number :
Provider Business Practice Location Address
First Line : 83 PROGRESS PKWY
Second Line :
City : MARYLAND HEIGHTS
State : MO
Zip : 63043-3701
Country : US
Telephone Number : 314-434-8174
Fax Number : 314-434-8706
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2005
Last Update Date : 02/20/2008

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