Dr. Samir Khattab El Mofty
Oral and Maxillofacial Pathology
425 S Euclid Ave 3rd Floor
Saint Louis
, Missouri 63110-1005
Dr. Samir Khattab El Mofty
Oral and Maxillofacial Pathology
425 S Euclid Ave 3rd Floor
Saint Louis
, Missouri 63110-1005
(314) 362-0369
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About
Features
Specialties
- Oral and Maxillofacial Pathology
Languages spoken
- English
Location
First Address
- Dr. Samir Khattab El Mofty
- 4253 Clayton Ave Cb 8118
- Saint Louis, MO
- Zip : 63110
- Fax : (314) 362-0369
- Phone : (314) 362-5641
Second Address
- Dr. Samir Khattab El Mofty
- 425 S Euclid Ave 3rd Floor
- Saint Louis, MO
- Zip : 63110-1005
- Fax : (314) 362-0369
- Phone : (314) 362-5641
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0106X | Oral and Maxillofacial Pathology | 014731 | MO |
National Provider Identifier
| NPI | 1558387878 |
|---|---|
| Provider Name | Dr. Samir Khattab El Mofty |
| First Address | Saint Louis, MO 63110 |
| Second Address | Saint Louis, MO 63110-1005 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 14/07/2006 |
| Last Update Date | 23/10/2015 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 019010176 | (05) | MO |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.