Healthcare Provider Details

I. General information

NPI: 1750306551
Provider Name (Legal Business Name): ANINDA B ACHARYA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ANINDA BHATTACHARYYA MD

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3009 N BALLAS RD STE 102B
SAINT LOUIS MO
63131-2343
US

IV. Provider business mailing address

660 MASON RIDGE CENTER DR STE 300
SAINT LOUIS MO
63141-8512
US

V. Phone/Fax

Practice location:
  • Phone: 314-996-7080
  • Fax: 314-996-7085
Mailing address:
  • Phone: 314-448-3791
  • Fax: 314-996-7085

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number2000154989
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: