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NPI Code Detail

MEDICARE: AMULYA SETHUMADHAVAN

MEDICARE: AMULYA SETHUMADHAVAN
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
1225100000XPhysical Therapist2025047004MO

General Provider Information

NPI Number : 1588523211
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMULYA SETHUMADHAVAN
Provider Business Mailing Address
First Line : 131 GUNSTON HALL DR
Second Line :
City : SAINT CHARLES
State : MO
Zip : 63304-1048
Country : US
Telephone Number : 479-372-3882
Fax Number :
Provider Business Practice Location Address
First Line : 7068 S OUTER 364
Second Line :
City : O FALLON
State : MO
Zip : 63368-7757
Country : US
Telephone Number : 479-372-3882
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2026
Last Update Date : 01/19/2026

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Directions to “ AMULYA SETHUMADHAVAN ” Practice Location

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