Provider Demographics
NPI:1255426748
Name:MISTRY, ALOO TEHMTON (MD)
Entity type:Individual
Prefix:DR
First Name:ALOO
Middle Name:TEHMTON
Last Name:MISTRY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13446 THORNHILL DRIVE
Mailing Address - Street 2:
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-1626
Mailing Address - Country:US
Mailing Address - Phone:314-984-0559
Mailing Address - Fax:
Practice Address - Street 1:13446 THORNHILL DRIVE
Practice Address - Street 2:
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-1626
Practice Address - Country:US
Practice Address - Phone:314-984-0559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO35702207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology