Healthcare Provider Details
I. General information
NPI: 1215953534
Provider Name (Legal Business Name): AMANDA FISHBACK CASHEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/14/2006
Last Update Date: 04/15/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4500 FOREST PARK AVE DIV IM BONE MARROW TRANSPLANT, 5TH, 6TH, 8TH FL
SAINT LOUIS MO
63108-2114
US
IV. Provider business mailing address
PO BOX 7412011
CHICAGO IL
60674-2011
US
V. Phone/Fax
- Phone: 314-454-8304
- Fax: 314-454-5902
- Phone: 314-454-8304
- Fax: 314-454-5902
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RX0202X |
| Taxonomy | Medical Oncology Physician |
| License Number | 2000168794 |
| License Number State | MO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: