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1275558082
FARID J AZZAM
SAINT LOUIS, MO
NPI
1275558082
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207L00000X Anesthesiology
(Licence: MO R9303)
Enumeration Date
2006-07-13
Last Update Date
2008-03-18
Business Address
-- FARID J AZZAM MD
3635 VISTA AVE
SAINT LOUIS, MO 63110-2539
Phone number: 314-577-8750
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Mailing Address
-- FARID J AZZAM MD
3691 RUTGER ST PROVIDER ENROLLMENT
SAINT LOUIS, MO 63110-2515
Phone number: 314-977-4440
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