Provider Demographics
NPI:1255395687
Name:ELBENDARY, ALAA A (MD)
Entity type:Individual
Prefix:DR
First Name:ALAA
Middle Name:A
Last Name:ELBENDARY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:11652 STUDT AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-7025
Mailing Address - Country:US
Mailing Address - Phone:314-991-5445
Mailing Address - Fax:314-991-5447
Practice Address - Street 1:11652 STUDT AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-7025
Practice Address - Country:US
Practice Address - Phone:314-991-5445
Practice Address - Fax:314-991-5447
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2021-10-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO110171207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
412030177OtherUNITED HEALTHCARE
MO33810OtherBCBS
MO7407000OtherMEDICARE COMPLETE
MOP00330196OtherRR MEDICARE
MO33180OtherBLUE CHOICE
F82867OtherMERCY
027213OtherFMH EXCLUSIVE CHOICE
288803OtherHEALTHLINK
412030177OtherGREAT WEST
121918OtherADVANTRA
121918OtherGROUP HEALTH PLAN
121918OtherCMR
412030177OtherGOLDEN RULE
412030177OtherCIGNA
121918OtherCMR
412030177OtherUNITED HEALTHCARE
MO957984982Medicare PIN