Healthcare Provider Details

I. General information

NPI: 1215138698
Provider Name (Legal Business Name): ARSHAD BHATT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1438 S GRAND BLVD
SAINT LOUIS MO
63104-1027
US

IV. Provider business mailing address

5544 POINCIANA BLVD
SAINT LOUIS MO
63123-2847
US

V. Phone/Fax

Practice location:
  • Phone: 314-577-8726
  • Fax:
Mailing address:
  • Phone: 314-353-5687
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number2003022296
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: