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Contact Information

ANIL K SRIVASTAVA, MD
12266 DE PAUL DR STE 305
BRIDGETON, MO63044-2514
 Phone: 314-770-0991
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery

208600000X 02 Physician/General Surgery
 

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
 

Surgical Critical Care

2086S0102X 02 Physician/General Surgery
 

Trauma Surgery

2086S0127X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for ANIL K SRIVASTAVA · (Male)

NPI Number 1205920220
Status Active
Credentials MD
Entity Individual
Enumeration date 10/03/2006
Last updated 03/07/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 036-090872
  • MO License # 2004034166
  • MO Medicaid 1205920220
  • MO Other 2004034166 LICENSE
  • MO Other 927594382 MEDICARE PTAN
Hospital affiliation(s)
  • CHRISTIAN HOSPITAL NORTHEAST - (Acute Care)
    11133 DUNN ROAD
    SAINT LOUIS, MO 63136
  • SSM DEPAUL HEALTH CENTER - (Acute Care)
    12303 DEPAUL DRIVE
    BRIDGETON, MO 63044
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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