Provider Demographics
NPI:1447212626
Name:ROJANASATHIT, CHINDA (MD)
Entity Type:Individual
Prefix:
First Name:CHINDA
Middle Name:
Last Name:ROJANASATHIT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1224 GRAHAM RD
Mailing Address - Street 2:SUITE 1113
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63031-8028
Mailing Address - Country:US
Mailing Address - Phone:314-839-4500
Mailing Address - Fax:314-839-8521
Practice Address - Street 1:1224 GRAHAM RD
Practice Address - Street 2:SUITE 1113
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63031-8028
Practice Address - Country:US
Practice Address - Phone:314-839-4500
Practice Address - Fax:314-839-8521
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO35367174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOA09932Medicare UPIN