Provider Demographics
NPI:1700887536
Name:SHROFF, KUMKUM JAGDISH (MD)
Entity Type:Individual
Prefix:DR
First Name:KUMKUM
Middle Name:JAGDISH
Last Name:SHROFF
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Gender:F
Credentials:MD
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Mailing Address - Street 1:533 COUCH AVE
Mailing Address - Street 2:SUITE # 155
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63122-5561
Mailing Address - Country:US
Mailing Address - Phone:314-965-2215
Mailing Address - Fax:314-965-3784
Practice Address - Street 1:533 COUCH AVE
Practice Address - Street 2:SUITE # 155
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63122-5561
Practice Address - Country:US
Practice Address - Phone:314-965-2215
Practice Address - Fax:314-965-3784
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-02
Last Update Date:2022-07-21
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Provider Licenses
StateLicense IDTaxonomies
MO35092207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOA10087Medicare UPIN