Ivaturi, Shyam S
Ivaturi, Shyam S is an individual health care provider with primary practice located at 12700 Southfork Rd Ste 280 , Saint Louis MO 63128-3287. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Ivaturi, Shyam S can be contacted via phone (314) 892-6565.Contact Information
Primary practice address
12700 Southfork Rd Ste 280
Saint Louis MO 63128-3287
Phone: (314) 892-6565
Fax: (314) 892-4828
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | 2001006095 | Missouri |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 2001006095 | Missouri |
Profile Details
| NPI number | 1881682904 |
|---|---|
| LBN Legal business name | Ivaturi, Shyam S |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 12th, 2005 |
| Last updated | Apr 16th, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1881682904 | NPPES |
| Missouri | MEDICAID | 205374135 |
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