Organization
ALYVE MEDICAL PLLC FAMILY MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMARDEEP SHRESTHA MD (MANAGER)
(217) 801-8156
Entity
Organization
Contact information
Practice address
1480 N GREEN MOUNT RD STE 200, O FALLON, IL 62269-3466
(618) 622-3450
(618) 622-3468
Mailing address
783 ALLENBROOK AVE, O FALLON, IL 62269-7455
(217) 801-8156
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RB0002X
Obesity Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
12/20/2021
Last updated
01/06/2022
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