ASHOK R MALLYA


Address: 915 N Grand Blvd, Saint Louis, MO 63106-1621
Phone: 3146524100

ASHOK R MALLYA (NPI# 1104873116) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1104873116
Entity Type Individual
Full Name ASHOK R MALLYA
Credential MD
Practice Address 915 N Grand Blvd
Saint Louis
MO 63106-1621
Mailing Address 12515 Windmoor Pl
Saint Louis
MO 63131-3019
Practice Telephone 3146524100
Mailing Telephone 3146524100
Enumeration Date 2006-05-27
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor X

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2084A0401X Psychiatry & Neurology
Specialization: Addiction Medicine
R6991 MO Allopathic & Osteopathic Physicians

Office Location

Street Address 915 N GRAND BLVD
City SAINT LOUIS
State MO
Zip Code 63106-1621

Providers in the same location

NPI Name Taxonomy Address Enumeration
1033115480 Jamie Lynn Swanson Physician Assistant 915 N Grand Blvd, Saint Louis, MO 63106-1621 2005-06-21
1821602756 Courtney Kay Duberry Optometrist 915 N Grand Blvd, Saint Louis, MO 63106-1621 2020-09-08
1043820053 Kathryn Marie Storm Pharmacist 915 N Grand Blvd, Saint Louis, MO 63106-1621 2020-08-04
1326657230 Rebecca Oluwafunmito Babalola Pharmacist 915 N Grand Blvd, Saint Louis, MO 63106-1621 2020-07-27
1639787328 Justin Clarke Liedke Pharmacist 915 N Grand Blvd, Saint Louis, MO 63106-1621 2020-07-19
1639796899 Taylor Anderson Nurse Practitioner 915 N Grand Blvd, Saint Louis, MO 63106-1621 2020-07-02
1427675800 Lauren Elizabeth Smith Nurse Practitioner 915 N Grand Blvd, Saint Louis, MO 63106-1621 2020-07-01
1427675925 Christa Marie Stoutenborough Nurse Practitioner 915 N Grand Blvd, Saint Louis, MO 63106-1621 2020-06-30
1992322739 Alexia Lambos Georges Perfusionist 915 N Grand Blvd, Saint Louis, MO 63106-1621 2020-06-27
1912522210 Meaghan Elizabeth Lecture Nurse Practitioner 915 N Grand Blvd, Saint Louis, MO 63106-1621 2020-06-11
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1770027997 Superior Manor of Downtown LLC Assisted Living Facility 1501 Clinton St., St Louis, MO 63106 2016-12-07
1811361454 James Preston Jr. Pharmacist 915 N. Grand Vlvd, Pharmacy Dept., John Cochran Va Medical Center, Saint Louis, MO 63106 2015-11-19
1245656354 Julie Marie Albsmeyer Physician Assistant 915 North Grand 111-jc-gi, John Cochran Va Hospital, St. Louis, MO 63106 2014-03-13
1932523230 Cathy Yeung Registered Nurse 715 N Grand Blvd., St Louis, MO 63106 2014-02-07
1902149388 Amanda Foley Doula 4056 Humphrey Street, Saint Louis, MO 63106 2013-04-03
1942569876 Cornelia Charles Internal Medicine 915 Norh Grand Blvd, Saint Louis, MO 63106 2012-05-12
1124334396 Kasandra Ann Tinajero Registered Nurse 915 N. Grand Blvd., St. Louis, MO 63106 2010-08-26
1366673931 Cassandra Vernetta Talbert Social Worker 915 N. Grand., 122/jc Social Work Dept. V.a. Medical Center, St. Louis, MO 63106 2009-07-30
1497910707 Robert Louis Tillman Pharmacy Technician 915 N Grand Ave, St. Louis, MO 63106 2008-07-25
1861676686 Bradley Dean Overmeyer Social Worker 915 N Grand Blvd., Social Work Service, St. Louis, MO 63106 2007-12-28
Find all providers in zip 63106

Taxonomy Information

Taxonomy Code 2084A0401X
Grouping Allopathic & Osteopathic Physicians
Classification Psychiatry & Neurology
Specialization Addiction Medicine

Taxonomy Definition

A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine
Notes: Source: American Osteopathic Board of Neurology and Psychiatry, 2007 [1/1/2008: definition added, source added; 7/1/2011: modified source]
- Additional Resources: http://www.osteopathic.org/certification

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1982928065 Jack L. Croughan Inc Psychiatry & Neurology 1034 S Brentwood Blvd, Suite 970, Saint Louis, MO 63117-1223 2010-03-18

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1760559181 Thomas James Breidenstein Psychiatry & Neurology 108 E Green Meadows Rd, Suite 8, Columbia, MO 65203-3633 2006-11-29
1235203308 David Edward Sternberg Psychiatry & Neurology 527 Sw Market St, Lees Summit, MO 64063-3918 2006-11-20
1689661829 Subbu Joseph Sarma Psychiatry & Neurology 4025 Ne Lakewood Way Ste 210, Lees Summit, MO 64064-2059 2005-10-03
1962819326 Oluwole Popoola Psychiatry & Neurology One Hospital Dr, Columbia, MO 65212 2014-07-17
1588659288 David Lee Ohlms Psychiatry & Neurology 12166 Old Big Bend Rd, Suite 100, Kirkwood, MO 63122-6844 2005-09-19

Competitor

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City SAINT LOUIS
Zip Code 63106

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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