Healthcare Provider Details

I. General information

NPI: 1821452863
Provider Name (Legal Business Name): CHESHIL P DIXIT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2016
Last Update Date: 08/04/2021
Certification Date: 08/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9701 LANDMARK PARKWAY DR STE 207
SAINT LOUIS MO
63127-1665
US

IV. Provider business mailing address

PO BOX 874797
KANSAS CITY MO
64187-4797
US

V. Phone/Fax

Practice location:
  • Phone: 314-849-8700
  • Fax:
Mailing address:
  • Phone: 314-849-8700
  • Fax: 314-849-8737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License Number2019018914
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: