Provider Demographics
NPI:1013908623
Name:AMATO, PATRICIA J (MD)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:J
Last Name:AMATO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 23340
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63156-3340
Mailing Address - Country:US
Mailing Address - Phone:314-965-5437
Mailing Address - Fax:314-965-5439
Practice Address - Street 1:9930 WATSON RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63126-1827
Practice Address - Country:US
Practice Address - Phone:314-965-5437
Practice Address - Fax:314-965-5439
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOR6E65208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO40903OtherGHP
MO92215275OtherBLUE SHIELD
MOA13911OtherMERCY
MS24319OtherBCBS
MO100151OtherHEALTHLINK
MO4000024OtherAETNA
MO1200154OtherUHC
MO1817V34311OtherHEALTHCARE USA
MOA13911Medicare UPIN