Basic Information
| Provider Information | |||||||||
| NPI: | 1053699108 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | METTU | ||||||||
| FirstName: | SANGEETA | ||||||||
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| Credential: | M.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | ONE HOSPITAL DRIVE, | ||||||||
| Address2: | DC018.00, MA202F | ||||||||
| City: | COLUMBIA | ||||||||
| State: | MO | ||||||||
| PostalCode: | 65202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5738828885 | ||||||||
| FaxNumber: | 5738844808 | ||||||||
| Practice Location | |||||||||
| Address1: | ONE HOSPITAL DRIVE, | ||||||||
| Address2: | DC018.00, MA202F | ||||||||
| City: | COLUMBIA | ||||||||
| State: | MO | ||||||||
| PostalCode: | 65202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5738828885 | ||||||||
| FaxNumber: | 5738844808 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/22/2011 | ||||||||
| LastUpdateDate: | 07/22/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 2011013283 | MO | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.