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NPI Code Detail

MEDICARE: DAIJI TAKAJO M.D.

MEDICARE: DAIJI TAKAJO M.D.
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
12080P0202XPediatric Cardiology Physician2026010882MO
22080P0202XPediatric Cardiology Physician036.179439IL

General Provider Information

NPI Number : 1619532306
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAIJI TAKAJO M.D.
Provider Business Mailing Address
First Line : 1465 S GRAND BLVD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63104-1003
Country : US
Telephone Number : 314-577-5633
Fax Number : 314-268-4035
Provider Business Practice Location Address
First Line : 1465 S GRAND BLVD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63104-1003
Country : US
Telephone Number : 314-577-5633
Fax Number : 314-268-4035
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2019
Last Update Date : 04/09/2026

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Directions to “ DAIJI TAKAJO M.D.” Practice Location

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