Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | S5537 | TX |
NPI | 1194138024 |
---|---|
Provider Name | Mr. Hassan A Ahmad |
First Address | Chesterfield, MO 63017-3663 |
Second Address | Chesterfield, MO 63017-3663 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2014 |
Last Update Date | 28/07/2021 |