Vissa, Sriram

Vissa, Sriram is an individual health care provider with primary practice located at 12303 De Paul Dr , Bridgeton MO 63044-2512. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Vissa, Sriram can be contacted via phone (314) 317-0600.

Contact Information

Primary practice address
12303 De Paul Dr Bridgeton MO 63044-2512
Phone: (314) 317-0600
Fax: (314) 317-0606
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 2004016757 Missouri
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 2004016757 Missouri

Profile Details

NPI number 1558334573
LBN Legal business name Vissa, Sriram
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 9th, 2006
Last updated Jun 19th, 2014 - about 10 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558334573 NPPES
Missouri MEDICAID 209220003
Missouri MEDICAID 1558334573

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