Provider Demographics
NPI:1477983906
Name:QUANTUM FLOW LLC
Entity Type:Organization
Organization Name:QUANTUM FLOW LLC
Other - Org Name:ADVANCED PODIATRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:AMOD
Authorized Official - Middle Name:P
Authorized Official - Last Name:PARANJPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-565-2772
Mailing Address - Street 1:5401 VETERANS MEMORIAL PKWY STE 102
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-1681
Mailing Address - Country:US
Mailing Address - Phone:636-442-1541
Mailing Address - Fax:636-244-2664
Practice Address - Street 1:5401 VETERANS MEMORIAL PKWY STE 102
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376
Practice Address - Country:US
Practice Address - Phone:636-442-1541
Practice Address - Fax:636-244-2664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-19
Last Update Date:2019-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO000733213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO308938604Medicaid
MO7396930001Medicare NSC
U61947Medicare UPIN
MO308938604Medicaid