Provider Demographics
NPI:1134433543
Name:POPURI, RADHA KRISHNA
Entity type:Individual
Prefix:DR
First Name:RADHA KRISHNA
Middle Name:
Last Name:POPURI
Suffix:
Gender:M
Credentials:
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Mailing Address - Street 1:510 S KINGSHIGHWAY BLVD
Mailing Address - Street 2:CAMPUS BOX 8131, MALLINCKRODT INSTITUTE OF RADIOLOGY
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1016
Mailing Address - Country:US
Mailing Address - Phone:314-362-2900
Mailing Address - Fax:314-362-2276
Practice Address - Street 1:510 S KINGSHIGHWAY BLVD
Practice Address - Street 2:CAMPUS BOX 8131, MALLINCKRODT INSTITUTE OF RADIOLOGY
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1016
Practice Address - Country:US
Practice Address - Phone:314-362-2900
Practice Address - Fax:314-362-2276
Is Sole Proprietor?:No
Enumeration Date:2010-07-28
Last Update Date:2010-07-28
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Provider Licenses
StateLicense IDTaxonomies
MO20100068522085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology