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General NPI Number Information
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NPI Number | 1316987837
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Entity Type | Individual
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Provider Name | AMIN RADPARVAR M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/07/2006
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Last Update Date | 10/30/2014
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Provider Practice Location Address
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Address Line | 70 JUNGERMANN CIR SUITE 401
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City | ST PETERS
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State | MO
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Zip | 63376-1622
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Country | US
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Telephone | 636-939-9004
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Fax | 636-922-9045
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Provider Business Mailing Address
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Address Line | 12401 OLIVE BLVD SUITE 207
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City | SAINT LOUIS
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State | MO
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Zip | 63141-5448
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Country | US
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Telephone | 314-878-5530
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Fax | 314-878-2435
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | MDR1G71
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License Number State | MO
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