Healthcare Provider Details

I. General information

NPI: 1033772892
Provider Name (Legal Business Name): ANDREA ELENA DAVIS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANDREA DAVIS PUENTE MD

II. Dates (important events)

Enumeration Date: 04/17/2019
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BARNES JEWISH HOSPITAL PLZ
SAINT LOUIS MO
63110-1003
US

IV. Provider business mailing address

660 S EUCLID AVE
SAINT LOUIS MO
63110-1010
US

V. Phone/Fax

Practice location:
  • Phone: 314-454-8917
  • Fax: 314-454-7524
Mailing address:
  • Phone: 314-454-8917
  • Fax: 314-454-7524

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number2026016998
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number2026016998
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number2026016998
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: