Provider Demographics
NPI:1457989642
Name:AMOR, BILEL (MD, AP)
Entity Type:Individual
Prefix:DR
First Name:BILEL
Middle Name:
Last Name:AMOR
Suffix:
Gender:M
Credentials:MD, AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1328 FORREST LANE CT
Mailing Address - Street 2:
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63011-4277
Mailing Address - Country:US
Mailing Address - Phone:314-255-5026
Mailing Address - Fax:
Practice Address - Street 1:400 N KEENE ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-6626
Practice Address - Country:US
Practice Address - Phone:573-882-4438
Practice Address - Fax:573-884-9992
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-01
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019027169208D00000X
MO2021019731208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice