MEDICARE: SWATI PATOLIA

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
1	207R00000X	Internal Medicine Physician	2015019907	MO
2	207RI0200X	Infectious Disease Physician	2015019907	MO

General Provider Information

NPI Number	:	1982952560
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SWATI PATOLIA

Provider Business Mailing Address
First Line	:	10004 KENNERLY RD STE 295B
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63128-2177
Country	:	US
Telephone Number	:	314-740-2949
Fax Number	:	314-375-5020

Provider Business Practice Location Address
First Line	:	10004 KENNERLY RD
Second Line	:	STE 295B
City	:	ST LOUIS
State	:	MO
Zip	:	63128-6312
Country	:	US
Telephone Number	:	314-740-2949
Fax Number	:	314-375-5020

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2012
Last Update Date	:	10/08/2024

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Directions to “ SWATI PATOLIA ” Practice Location

Language	Start Address	Practice Location

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