Provider Demographics
NPI:1982620100
Name:KUNDRA, ROBIN ANN (MD PHD)
Entity type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:ANN
Last Name:KUNDRA
Suffix:
Gender:F
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 N TAYLOR AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108-2102
Mailing Address - Country:US
Mailing Address - Phone:314-534-8600
Mailing Address - Fax:314-652-8138
Practice Address - Street 1:114 N TAYLOR AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-2102
Practice Address - Country:US
Practice Address - Phone:314-534-8600
Practice Address - Fax:314-652-8138
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003011035207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO902464500Medicaid
MO902464500Medicaid