Provider Demographics
NPI:1184608689
Name:GANDHI, SNEHAL R (MD)
Entity type:Individual
Prefix:
First Name:SNEHAL
Middle Name:R
Last Name:GANDHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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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:314-645-3743
Mailing Address - Fax:314-647-7967
Practice Address - Street 1:1027 BELLEVUE AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63117-1851
Practice Address - Country:US
Practice Address - Phone:314-645-3743
Practice Address - Fax:314-647-7967
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2012-09-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO103468207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO203829007Medicaid
MOP00732182OtherRAILROAD MEDICARE
MO40010581OtherCPIN
MO203829015Medicaid
MO203829015Medicaid