Provider Demographics
NPI:1134329519
Name:AIMA NEUROLOGY LLC
Entity Type:Organization
Organization Name:AIMA NEUROLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:XIAO-YUE
Authorized Official - Last Name:MA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-984-8380
Mailing Address - Street 1:PO BOX 410290
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-0290
Mailing Address - Country:US
Mailing Address - Phone:314-984-8380
Mailing Address - Fax:314-984-5091
Practice Address - Street 1:2315 DOUGHERTY FERRY RD
Practice Address - Street 2:SUITE 207
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63122-3383
Practice Address - Country:US
Practice Address - Phone:314-984-8380
Practice Address - Fax:314-984-5091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-23
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1062972084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO0500157OtherUNITED HEALTH CARE
MO108428OtherBLUE CROSS ATHEM
MO208715508Medicaid
MO5868624OtherAETNA
MO333473OtherHEALTH LINK
MO218597OtherGROUP HEALTH PLAN
MO218597OtherGROUP HEALTH PLAN
MO001014326Medicare PIN