Provider Demographics
NPI:1356830830
Name:WEST COUNTY RHEUMATOLOGY, LLC
Entity Type:Organization
Organization Name:WEST COUNTY RHEUMATOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SONA
Authorized Official - Middle Name:S
Authorized Official - Last Name:KAMAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-983-9898
Mailing Address - Street 1:13100 MANCHESTER RD STE 70
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-1703
Mailing Address - Country:US
Mailing Address - Phone:314-492-2323
Mailing Address - Fax:314-582-1010
Practice Address - Street 1:13100 MANCHESTER RD STE 70
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-1703
Practice Address - Country:US
Practice Address - Phone:314-492-2323
Practice Address - Fax:314-582-1010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-09
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003014471207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty