Provider Demographics
NPI:1053337360
Name:ZISKIND, ANDREW A (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:A
Last Name:ZISKIND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:660 S EUCLID AVE
Mailing Address - Street 2:C B 8086
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1010
Mailing Address - Country:US
Mailing Address - Phone:314-362-1291
Mailing Address - Fax:314-747-9013
Practice Address - Street 1:4921 PARKVIEW PL
Practice Address - Street 2:STE 8A
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1032
Practice Address - Country:US
Practice Address - Phone:314-362-1291
Practice Address - Fax:314-747-9013
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2009-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2005016228207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO207393307Medicaid
IL$$$$$$$$$Medicaid
E66136Medicare UPIN
IL$$$$$$$$$Medicaid
933490183Medicare PIN