Individual
DR. AMITA R BHALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
12200 WEBER HILL RD STE 100, SAINT LOUIS, MO 63127-1599
(314) 698-2500
(314) 698-2323
Mailing address
12200 WEBER HILL RD STE 100, SAINT LOUIS, MO 63127-1599
(314) 698-2500
(314) 698-2323
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
R3K09
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01134538
RAILROAD MEDICARE
MO
Enumeration date
08/05/2006
Last updated
03/12/2018
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