Infectious Disease Physicians LLC

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

2004025502 Issued in MO

Legal business name

INFECTIOUS DISEASE PHYSICIANS LLC

Practice address

10010 Kennerly Rd
Saint Louis, MO 63128-2106

Phone

(636) 333-4500

NPI assigned

Mar 2, 2011

Last updated

Jul 18, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Rajeev Dewan, MD

Title

President

Phone

(636) 333-4500

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1299024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342569600000",
    "number": "1164720041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1413",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622698413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10010 KENNERLY RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282106",
            "telephone_number": "636-333-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFECTIOUS DISEASE PHYSICIANS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-02",
        "last_updated": "2012-07-18",
        "status": "A",
        "authorized_official_last_name": "DEWAN",
        "authorized_official_first_name": "RAJEEV",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "636-333-4500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MO",
            "license": "2004025502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Infectious Disease Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Infectious Disease Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.