Dr. Anil Kumar Srivastava
Surgeon Emergency Physician Trauma Surgeon Surgical Critical Care
12266 De Paul Dr Ste 305
Bridgeton
, Missouri 63044-2514
Dr. Anil Kumar Srivastava
Surgeon Emergency Physician Trauma Surgeon Surgical Critical Care
12266 De Paul Dr Ste 305
Bridgeton
, Missouri 63044-2514
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About
Features
Specialties
- Emergency Physician
- Surgeon
- Surgical Critical Care
- Trauma Surgeon
Languages spoken
- English
Location
First Address
- Dr. Anil Kumar Srivastava
- Po Box 955534
- Saint Louis, MO
- Zip : 63195-5534
- Phone :
Second Address
- Dr. Anil Kumar Srivastava
- 12266 De Paul Dr Ste 305
- Bridgeton, MO
- Zip : 63044-2514
- Phone : (314) 770-0991
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207P00000X | Emergency Physician | 036-090872 | IL |
| Y | 208200000X | Surgeon | 2004034166 | MO |
| Y | 208600000X | Surgeon | 2004034166 | MO |
| N | 2086S0102X | Surgical Critical Care | 2004034166 | MO |
| N | 2086S0127X | Trauma Surgeon | 2004034166 | MO |
National Provider Identifier
| NPI | 1205920220 |
|---|---|
| Provider Name | Dr. Anil Kumar Srivastava |
| First Address | Saint Louis, MO 63195-5534 |
| Second Address | Bridgeton, MO 63044-2514 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 03/10/2006 |
| Last Update Date | 01/12/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1205920220 | (05) | MO |
| 2004034166 | LICENSE (01) | MO |
| 927594382 | MEDICARE PTAN (01) | MO |
| BS4522858 | DEA (01) | MO |
| G37574 | (02) | MO |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.