Healthcare Provider Details

I. General information

NPI: 1699948745
Provider Name (Legal Business Name): ASHLEY A EMMERT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ASHLEY S ANDERSON MD

II. Dates (important events)

Enumeration Date: 04/09/2008
Last Update Date: 05/07/2024
Certification Date: 05/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6555 CHIPPEWA ST STE 100
SAINT LOUIS MO
63109-4110
US

IV. Provider business mailing address

6555 CHIPPEWA ST STE 100
SAINT LOUIS MO
63109-4110
US

V. Phone/Fax

Practice location:
  • Phone: 314-520-9783
  • Fax: 888-316-7781
Mailing address:
  • Phone: 314-833-4905
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number2009012277
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: