Provider Demographics
NPI:1467401828
Name:AMATO, JOSH E (MD)
Entity Type:Individual
Prefix:
First Name:JOSH
Middle Name:E
Last Name:AMATO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JOSH
Other - Middle Name:E
Other - Last Name:AMATO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:621 S NEW BALLAS RD
Mailing Address - Street 2:SUITE 5006B
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8232
Mailing Address - Country:US
Mailing Address - Phone:314-432-5478
Mailing Address - Fax:314-569-0864
Practice Address - Street 1:621 S NEW BALLAS RD
Practice Address - Street 2:SUITE 5006B
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8232
Practice Address - Country:US
Practice Address - Phone:314-432-5478
Practice Address - Fax:314-569-0864
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006011477207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO208747OtherBCBS
MO749220OtherHEALTHLINK
MO201050200Medicaid
MOI13689Medicare UPIN
MO208747OtherBCBS
MO957113442Medicare PIN