Provider Demographics
NPI:1588644488
Name:ANEES, AMEENA (MD)
Entity Type:Individual
Prefix:DR
First Name:AMEENA
Middle Name:
Last Name:ANEES
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 1:1513 UNION AVE
Mailing Address - Street 2:STE 1600
Mailing Address - City:MOBERLY
Mailing Address - State:MO
Mailing Address - Zip Code:65270-9407
Mailing Address - Country:US
Mailing Address - Phone:660-263-2400
Mailing Address - Fax:660-263-5610
Practice Address - Street 1:1513 UNION AVE
Practice Address - Street 2:STE 1600
Practice Address - City:MOBERLY
Practice Address - State:MO
Practice Address - Zip Code:65270-9407
Practice Address - Country:US
Practice Address - Phone:660-263-2400
Practice Address - Fax:660-263-5610
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO101572207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO208851907Medicaid
MO002013765OtherMEDICARE ID
MO002013765OtherMEDICARE ID
MO208851907Medicaid
MO002013765Medicare PIN