Individual
DR. ALI A EHSANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
915 N GRAND BLVD, CARDIOLOGY DIVISION, BLDG 1 ROOM C219, SAINT LOUIS, MO 63106-1621
(314) 289-6309
(314) 289-7029
Mailing address
915 N GRAND BLVD, CARDIOLOGY DIVISION, ROOM C219 BLDG 1, SAINT LOUIS, MO 63106-1621
(314) 289-6309
(314) 289-7029
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
R7158
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201013000
—
MO
01
—
26569
MO-BLUE SHIELD
—
Enumeration date
07/14/2006
Last updated
05/19/2008
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