Provider Demographics
NPI:1982952560
Name:PATOLIA, SWATI
Entity Type:Individual
Prefix:
First Name:SWATI
Middle Name:
Last Name:PATOLIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9735 LANDMARK PARKWAY DR 200
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63127-1666
Mailing Address - Country:US
Mailing Address - Phone:314-543-6985
Mailing Address - Fax:314-543-6836
Practice Address - Street 1:10004 KENNERLY RD
Practice Address - Street 2:STE 295B
Practice Address - City:ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-6312
Practice Address - Country:US
Practice Address - Phone:314-740-2949
Practice Address - Fax:314-375-5020
Is Sole Proprietor?:No
Enumeration Date:2012-08-29
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015019907207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine