| Dr Farrokh Dehdashti, MD | |
|
510 S Kingshighway Blvd, Dept Radiology, Saint Louis, MO 63110-1016 | |
| (314) 362-7200 | |
| (314) 747-4189 |
| Full Name | Dr Farrokh Dehdashti |
|---|---|
| Gender | Female |
| Speciality | Nuclear Medicine |
| Experience | 49 Years |
| Location | 510 S Kingshighway Blvd, Saint Louis, Missouri |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063506392 | NPI | - | NPPES |
| 209724707 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | R9H91 (Missouri) | Secondary |
| 207U00000X | Nuclear Medicine | R9H91 (Missouri) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Barnes Jewish Hospital | Saint louis, MO | Hospital |
| Barnes-jewish West County Hospital | Creve coeur, MO | Hospital |
| Missouri Baptist Medical Center | Town and country, MO | Hospital |
| Christian Hospital Northeast | Saint louis, MO | Hospital |
| Barnes-jewish St Peters Hospital | Saint peters, MO | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Washington University | 9830008770 | 3047 |
| Miracl Llc | 4587908041 | 100 |
| Entity Name | Washington University |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1962442475 PECOS PAC ID: 9830008770 Enrollment ID: O20031204000987 |
| Entity Name | Miracl Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1205304300 PECOS PAC ID: 4587908041 Enrollment ID: O20181210003487 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Farrokh Dehdashti, MD Po Box 7412011, Chicago, IL 60674-2011 Ph: (314) 362-7200 | Dr Farrokh Dehdashti, MD 510 S Kingshighway Blvd, Dept Radiology, Saint Louis, MO 63110-1016 Ph: (314) 362-7200 |