Provider Demographics
NPI:1194829465
Name:HANDA, JAHNAVI (MD)
Entity Type:Individual
Prefix:DR
First Name:JAHNAVI
Middle Name:
Last Name:HANDA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12738 WYNFIELD PINES CT
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-2156
Mailing Address - Country:US
Mailing Address - Phone:314-965-5220
Mailing Address - Fax:314-596-4398
Practice Address - Street 1:12738 WYNFIELD PINES CT
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-2156
Practice Address - Country:US
Practice Address - Phone:314-965-5220
Practice Address - Fax:314-965-0176
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-08
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004072772084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO208748707Medicaid
MO208748707Medicaid
MOH12120Medicare UPIN