| NPI | 1518764935 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABID NISAR Medical Director 314-546-6072 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 251G00000X Hospice Care, Community Based |
| 251J00000X Nursing Care | |
| 261QI0500X Clinic/Center, Infusion Therapy | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QP2000X Clinic/Center, Physical Therapy | |
| 261QP2300X Clinic/Center, Primary Care | |
| 261QP3300X Clinic/Center, Pain | |
| 261QR0208X Clinic/Center, Radiology, Mobile | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 261QU0200X Clinic/Center, Urgent Care | |
| 291U00000X Clinical Medical Laboratory | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 3336C0002X Pharmacy, Clinic Pharmacy | |
| 335G00000X Medical Foods Supplier | |
| Enumeration Date | 2025-02-25 |
| Last Update Date | 2025-02-25 |