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General NPI Number Information
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NPI Number | 1134329519
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Entity Type | Organization
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Legal Business Name | AIMA NEUROLOGY LLC
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Dates
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Enumeration Date | 07/23/2007
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Last Update Date | 06/13/2011
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Provider Practice Location Address
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Address Line | 2315 DOUGHERTY FERRY RD SUITE 207
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City | SAINT LOUIS
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State | MO
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Zip | 63122-3383
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Country | US
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Telephone | 314-984-8380
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Fax | 314-984-5091
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Provider Business Mailing Address
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Address Line | PO BOX 410290
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City | SAINT LOUIS
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State | MO
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Zip | 63141-0290
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Country | US
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Telephone | 314-984-8380
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Fax | 314-984-5091
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Authorized Official
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Title or Position | CEO
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Name | DR. SHERRY XIAO-YUE MA
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Credential | MD
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Telephone | 314-984-8380
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 106297
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License Number State | MO
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