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General NPI Number Information
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NPI Number | 1205052727
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Entity Type | Organization
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Legal Business Name | DR ARDEKANIS STRESS CLINIC, PC
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 05/21/2015
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Provider Practice Location Address
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Address Line | SUITE 310A 10004 KENNERLY RD
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City | ST LOUIS
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State | MO
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Zip | 63128-5117
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Country | US
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Telephone | 314-843-3310
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Fax | 314-843-8825
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Provider Business Mailing Address
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Address Line | 10004 KENNERLY RD SUITE 310A
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City | SAINT LOUIS
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State | MO
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Zip | 63128-2141
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Country | US
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Telephone | 314-843-3310
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Fax | 314-843-8825
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AHMAD BEHESHTI ARDEKANI
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Credential | MD
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Telephone | 314-843-3310
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 35941
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License Number State | MO
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