Provider Demographics
NPI:1780788976
Name:ROJANASATHIT, SOMKIETR (MD)
Entity type:Individual
Prefix:DR
First Name:SOMKIETR
Middle Name:
Last Name:ROJANASATHIT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11155 DUNN ROAD
Mailing Address - Street 2:SUITE 201E
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63136
Mailing Address - Country:US
Mailing Address - Phone:314-355-3175
Mailing Address - Fax:314-355-5175
Practice Address - Street 1:11155 DUNN ROAD
Practice Address - Street 2:SUITE 201E
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63136
Practice Address - Country:US
Practice Address - Phone:314-355-3175
Practice Address - Fax:314-355-5175
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO35075207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
177904OtherBLUE SHIELD
177904OtherBLUE SHIELD