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General NPI Number Information
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NPI Number | 1962711937
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Entity Type | Individual
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Provider Name | AMIT WASUDEO BHANDARKAR MD
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Gender | Male
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Dates
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Enumeration Date | 09/24/2010
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Last Update Date | 09/12/2024
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Provider Practice Location Address
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Address Line | 16216 BAXTER RD BLDG SUITE110
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City | CHESTERFIELD
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State | MO
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Zip | 63017-4770
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Country | US
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Telephone | 618-417-7463
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 55309
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City | BIRMINGHAM
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State | AL
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Zip | 35255-5309
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Country | US
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Telephone | 205-731-9701
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | L3267
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License Number State | AL
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