MEDICARE: DR. LALITHKUMAR K CHOUHAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	036073350	IL
2	207RC0000X	Cardiovascular Disease Physician	R2E98	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	6287491	OTHER		CIGNA
2	006029924	OTHER	MO	MORRMCR
3	5567V8816	OTHER		HCUSA
4	229043	OTHER		HLNK
5	2500129	OTHER		UHC
6	27698	OTHER	MO	MOBS/BLCHOICE
7	F18347	OTHER		MERCY
8	000000012519	OTHER		ESSENCE
9	060067892	OTHER	IL	ILRRMCR
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	431098908	OTHER		TRICARE
12	1455V3831	OTHER		GHP/CMR
13	4379428	OTHER		AETNA

General Provider Information

NPI Number	:	1124011028
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LALITHKUMAR K CHOUHAN MD

Provider Business Mailing Address
First Line	:	11125 DUNN RD
Second Line	:	STE 204
City	:	SAINT LOUIS
State	:	MO
Zip	:	63136-6132
Country	:	US
Telephone Number	:	314-839-5522
Fax Number	:	314-839-5351

Provider Business Practice Location Address
First Line	:	11125 DUNN RD
Second Line	:	STE 204
City	:	SAINT LOUIS
State	:	MO
Zip	:	63136-6132
Country	:	US
Telephone Number	:	314-839-5522
Fax Number	:	314-839-5351

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2005
Last Update Date	:	12/02/2021

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