Basic Information
| Provider Information | |||||||||
| NPI: | 1124013487 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RAIKAR | ||||||||
| FirstName: | SUDHIR | ||||||||
| MiddleName: | R | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 920 BELLERIVE MANOR DR | ||||||||
| Address2: | |||||||||
| City: | CREVE COEUR | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631416094 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3144346841 | ||||||||
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| Practice Location | |||||||||
| Address1: | 83 PROGRESS PKWY | ||||||||
| Address2: | |||||||||
| City: | MARYLAND HEIGHTS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 630433701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3144348174 | ||||||||
| FaxNumber: | 3144348706 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/13/2005 | ||||||||
| LastUpdateDate: | 02/20/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207PP0204X | R8500 | MO | Y | Allopathic & Osteopathic Physicians | Emergency Medicine | Pediatric Emergency Medicine |
No ID Information.