Provider Demographics
NPI:1093240897
Name:ANAND, KEERTHANA (MD, MBBS, MS)
Entity Type:Individual
Prefix:
First Name:KEERTHANA
Middle Name:
Last Name:ANAND
Suffix:
Gender:F
Credentials:MD, MBBS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15838 FOUNTAIN PLAZA DR STE A
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-7469
Mailing Address - Country:US
Mailing Address - Phone:636-484-5220
Mailing Address - Fax:
Practice Address - Street 1:15838 FOUNTAIN PLAZA DR STE A
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-7469
Practice Address - Country:US
Practice Address - Phone:636-484-5220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-29
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS7167207Q00000X
OK36931207Q00000X
MO2023039089207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine