Healthcare Provider Details

I. General information

NPI: 1487230884
Provider Name (Legal Business Name): HARSHA VENKATA AKULA MOGALAPALLI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HARSHA AKULA

II. Dates (important events)

Enumeration Date: 03/24/2021
Last Update Date: 07/01/2024
Certification Date: 07/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WUSM PEDS, 1 CHILDRENS PL MSC 8208-0016-06
ST. LOUIS MO
63110
US

IV. Provider business mailing address

WUSM PEDS, 1 CHILDRENS PL MSC 8208-0016-06
ST. LOUIS MO
63110
US

V. Phone/Fax

Practice location:
  • Phone: 314-454-6050
  • Fax: 855-887-7850
Mailing address:
  • Phone: 314-454-6050
  • Fax: 855-887-7850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License Number2024025974
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2024025974
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: