=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528299930
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LAKSHMI V. DUNDOO, MD, PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/03/2009
-----------------------------------------------------
Last Update Date | 08/03/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10004 KENNERLY ROAD SUITE 271 B
-----------------------------------------------------
City | SAINT LOUIS
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63128
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 314-842-0443
-----------------------------------------------------
Fax | 314-842-8348
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 14 OVERHILLS DR
-----------------------------------------------------
City | SAINT LOUIS
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63124-1532
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 314-842-0443
-----------------------------------------------------
Fax | 314-842-8348
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN
-----------------------------------------------------
Name | DR. LAKSHMI DUNDOO
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 314-842-0443
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------