Provider Demographics
NPI:1306846027
Name:AMANAT, ALEX H (MD)
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:H
Last Name:AMANAT
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Gender:M
Credentials:MD
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Mailing Address - Street 1:11903 SAINT CHARLES ROCK RD
Mailing Address - Street 2:
Mailing Address - City:BRIDGETON
Mailing Address - State:MO
Mailing Address - Zip Code:63044-2623
Mailing Address - Country:US
Mailing Address - Phone:314-770-0900
Mailing Address - Fax:314-739-8569
Practice Address - Street 1:5422 SOUTHFIELD CTR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63123-5907
Practice Address - Country:US
Practice Address - Phone:314-842-0707
Practice Address - Fax:314-842-0730
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-22
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MO35661207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I31182Medicare UPIN