Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 2009021871 | MO |
NPI | 1093946873 |
---|---|
Provider Name | Dr. Suaiman Syed Shoab |
First Address | Bangor, GWYNEDD LL57 2LJ |
Second Address | Saint Louis, MO 63110-2539 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2009 |
Last Update Date | 28/07/2009 |