Provider Demographics
NPI:1275194839
Name:CHAMESSIAN, ALEXANDER GEORGE (MD PHD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:GEORGE
Last Name:CHAMESSIAN
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7412011
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-2011
Mailing Address - Country:US
Mailing Address - Phone:314-996-8631
Mailing Address - Fax:314-996-8742
Practice Address - Street 1:1044 N MASON RD
Practice Address - Street 2:DEPT ANESTHESIOLOGY, STE L30
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-6431
Practice Address - Country:US
Practice Address - Phone:314-996-8631
Practice Address - Fax:314-996-8742
Is Sole Proprietor?:No
Enumeration Date:2019-06-25
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023022542207LP2900X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200072045Medicaid