Basic Information
| Provider Information | |||||||||
| NPI: | 1265669394 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KANURI | ||||||||
| FirstName: | NAVYA | ||||||||
| MiddleName: | DEEPTHI | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 222 S WOODS MILL RD STE 760 | ||||||||
| Address2: | |||||||||
| City: | CHESTERFIELD | ||||||||
| State: | MO | ||||||||
| PostalCode: | 630173625 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3142056050 | ||||||||
| FaxNumber: | 3144345939 | ||||||||
| Practice Location | |||||||||
| Address1: | 222 S WOODS MILL RD STE 760 | ||||||||
| Address2: | |||||||||
| City: | CHESTERFIELD | ||||||||
| State: | MO | ||||||||
| PostalCode: | 630173625 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3142056050 | ||||||||
| FaxNumber: | 3144345939 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2009 | ||||||||
| LastUpdateDate: | 04/14/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/14/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 2009006290 | MO | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RG0100X | Q6522 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.