Provider Demographics
NPI:1114134186
Name:GAZIT, AVIHU (MD)
Entity Type:Individual
Prefix:DR
First Name:AVIHU
Middle Name:
Last Name:GAZIT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CHILDRENS PL
Mailing Address - Street 2:MSC 8208-16-01
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1002
Mailing Address - Country:US
Mailing Address - Phone:314-454-2527
Mailing Address - Fax:314-747-8880
Practice Address - Street 1:1 CHILDRENS PL
Practice Address - Street 2:DIV PED CRITICAL CARE MED
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1002
Practice Address - Country:US
Practice Address - Phone:314-454-2527
Practice Address - Fax:314-747-8880
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007012445208000000X, 2080P0202X, 2080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO207217407Medicaid
MO207217407Medicaid
IL$$$$$$$$$Medicaid
MO324890381Medicaid
MO324890381Medicare PIN