# DESILVA MEDICAL SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184757072
- **Authorized official:** DR. ANANDA DESILVA M.D. (PHYSICIAN OWNER)
- **Authorized official phone:** (314) 731-5555

## Contact information

- **Practice address:** 6308 HAZELWEST CT, SUITE 200, HAZELWOOD, MO 63042-1739
- **Practice address phone:** (314) 731-5555
- **Practice address fax:** (314) 731-5558
- **Mailing address:** 6308 HAZELWEST CT, SUITE 200, HAZELWOOD, MO 63042-1739
- **Mailing address phone:** (314) 731-5555
- **Mailing address fax:** (314) 731-5558

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RA0000X | Adolescent Medicine (Internal Medicine) Physician | R9845 | MO | Yes |

## Other

- **Enumeration date:** 03/13/2007
- **Last updated:** 08/22/2020