Provider Demographics
NPI:1912286592
Name:DORI, AMIR (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:AMIR
Middle Name:
Last Name:DORI
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7530 OXFORD DR
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:MO
Mailing Address - Zip Code:63105-2808
Mailing Address - Country:US
Mailing Address - Phone:314-398-8749
Mailing Address - Fax:
Practice Address - Street 1:7530 OXFORD DR
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:MO
Practice Address - Zip Code:63105-2808
Practice Address - Country:US
Practice Address - Phone:314-398-8749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-12
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011016959204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM