Provider Demographics
NPI:1154448207
Name:DELOS SANTOS, ROWENA BAYUDAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ROWENA
Middle Name:BAYUDAN
Last Name:DELOS SANTOS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 60352
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63160-0352
Mailing Address - Country:US
Mailing Address - Phone:314-362-7603
Mailing Address - Fax:314-747-5213
Practice Address - Street 1:4921 PARKVIEW PL
Practice Address - Street 2:DIV IM NEPHROLOGY, STE 5C
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1032
Practice Address - Country:US
Practice Address - Phone:314-362-7603
Practice Address - Fax:314-747-5213
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2024-04-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2012013845207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO209849306Medicaid