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General NPI Number Information
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NPI Number | 1417994559
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Entity Type | Individual
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Provider Name | HANY BOTROS TADROS MD
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Gender | Male
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Dates
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Enumeration Date | 05/31/2006
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Last Update Date | 02/19/2025
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Provider Practice Location Address
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Address Line | 11133 DUNN RD
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City | SAINT LOUIS
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State | MO
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Zip | 63136-6119
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Country | US
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Telephone | 865-985-7253
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Fax |
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Provider Business Mailing Address
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Address Line | 548 OAK CREEK MEADOWS CT
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City | CHESTERFIELD
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State | MO
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Zip | 63017-2110
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Country | US
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Telephone |
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Fax |
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 036119032
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | ME110459
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | MD114623
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License Number State | MO
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