Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 2001024923 | MO |
NPI | 1316908155 |
---|---|
Provider Name | Dr. Nabil Ahmad |
First Address | Creve Coeur, MO 63141-2024 |
Second Address | Saint Louis, MO 63141-8667 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2006 |
Last Update Date | 15/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G36676 | (02) | MO |