Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 113308 | MO |
Y | 2080N0001X | Neonatal-Perinatal Doctor | 113308 | MO |
NPI | 1053351338 |
---|---|
Provider Name | Mohamad Al-Hosni |
First Address | Chesterfield, MO 63017-2415 |
Second Address | Chesterfield, MO 63017-2415 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2006 |
Last Update Date | 14/10/2020 |