Provider Demographics
NPI:1740400886
Name:NAIDU, RAJYALAKSHMI GONUGUNTLA (MD)
Entity Type:Individual
Prefix:MRS
First Name:RAJYALAKSHMI
Middle Name:GONUGUNTLA
Last Name:NAIDU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:12541 CONWAY DOWNS DRIVE
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS
Mailing Address - State:MI
Mailing Address - Zip Code:63141
Mailing Address - Country:US
Mailing Address - Phone:314-576-7114
Mailing Address - Fax:
Practice Address - Street 1:6420 CLAYTON RD
Practice Address - Street 2:ST MARYS HEALTH CENTER
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63117-1811
Practice Address - Country:US
Practice Address - Phone:314-768-8202
Practice Address - Fax:314-768-7145
Is Sole Proprietor?:No
Enumeration Date:2007-04-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOR9756207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology