Healthcare Provider Details

I. General information

NPI: 1659512838
Provider Name (Legal Business Name): AMAR DHAND MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2009
Last Update Date: 12/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4455 DUNCAN AVE
SAINT LOUIS MO
63110-1111
US

IV. Provider business mailing address

660 S EUCLID AVE C B 8111
SAINT LOUIS MO
63110-1010
US

V. Phone/Fax

Practice location:
  • Phone: 314-362-7241
  • Fax: 314-362-0338
Mailing address:
  • Phone: 314-362-7241
  • Fax: 314-362-0338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number2013015294
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number2013015294
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number266766
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: