Provider Demographics
NPI:1750306551
Name:ACHARYA, ANINDA B (MD)
Entity Type:Individual
Prefix:
First Name:ANINDA
Middle Name:B
Last Name:ACHARYA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ANINDA
Other - Middle Name:
Other - Last Name:BHATTACHARYYA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:660 MASON RIDGE CENTER DR STE 300
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8512
Mailing Address - Country:US
Mailing Address - Phone:314-448-3791
Mailing Address - Fax:314-996-7085
Practice Address - Street 1:3009 N BALLAS RD STE 102B
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-2343
Practice Address - Country:US
Practice Address - Phone:314-996-7080
Practice Address - Fax:314-996-7085
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20001549892084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology