Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 2009009436 | MO |
Y | 2080N0001X | Neonatal-Perinatal Doctor | 2009009436 | MO |
NPI | 1023227451 |
---|---|
Provider Name | Dr. Shakir Mohamed |
First Address | Saint Louis, MO 63104-1003 |
Second Address | Saint Louis, MO 63104-1003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2007 |
Last Update Date | 19/01/2021 |