MEDICARE: DR. ARCHANA S ABHYANKAR 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	2085R0202X	Diagnostic Radiology Physician	63132	PA
2	2085R0202X	Diagnostic Radiology Physician	MD0000051435	TN
3	2085R0202X	Diagnostic Radiology Physician	2010006684	MO
4	2085R0202X	Diagnostic Radiology Physician	0101257179	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	A035950825	OTHER	TN	TN MEDICARE
4	MA5253006	OTHER	MO	MISSOURI MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477710051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARCHANA S ABHYANKAR MD

Provider Business Mailing Address
First Line	:	1415 ELBRIDGE PAYNE RD STE 120
Second Line	:
City	:	CHESTERFIELD
State	:	MO
Zip	:	63017-8522
Country	:	US
Telephone Number	:	636-728-2221
Fax Number	:	636-519-7965

Provider Business Practice Location Address
First Line	:	16091 SWINGLEY RIDGE RD STE 100
Second Line	:
City	:	CHESTERFIELD
State	:	MO
Zip	:	63017-2056
Country	:	US
Telephone Number	:	314-238-5260
Fax Number	:	314-821-1833

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

Provider Enumeration Date	:	05/21/2008
Last Update Date	:	07/24/2025

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