Basic Information
| Provider Information | |||||||||
| NPI: | 1659866580 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GUNIGANTI | ||||||||
| FirstName: | RIDHIMA | ||||||||
| MiddleName: | RAO | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 660 SOUTH EUCLID | ||||||||
| Address2: | NEUROSURGERY, BOX 8057 | ||||||||
| City: | SAINT LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 63110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3143625000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1 BARNES JEWISH HOSPITAL PLZ | ||||||||
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| City: | SAINT LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631101003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3143625000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/23/2018 | ||||||||
| LastUpdateDate: | 06/23/2018 | ||||||||
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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 | 207T00000X | 2018018350 | MO | Y | Allopathic & Osteopathic Physicians | Neurological Surgery |
No ID Information.