Healthcare Provider Details

I. General information

NPI: 1144955055
Provider Name (Legal Business Name): ADITYA SHRIKHANDE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2022
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 W LIBERTY ST
FARMINGTON MO
63640-1921
US

IV. Provider business mailing address

PO BOX 957683
SAINT LOUIS MO
63195-7683
US

V. Phone/Fax

Practice location:
  • Phone: 573-705-1272
  • Fax: 573-705-1216
Mailing address:
  • Phone: 573-705-1272
  • Fax: 573-705-1216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number39458
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number2025028055
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: