MEDICARE: DR. MONZER NAJI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	109502	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	105654	OTHER		ALLIANCE
2	4466878	OTHER	MO	AETNA

General Provider Information

NPI Number	:	1578568689
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MONZER NAJI M.D.

Provider Business Mailing Address
First Line	:	4150 JEFFCO BLVD
Second Line	:
City	:	ARNOLD
State	:	MO
Zip	:	63010-4234
Country	:	US
Telephone Number	:	636-464-1000
Fax Number	:

Provider Business Practice Location Address
First Line	:	4150 JEFFCO BLVD
Second Line	:
City	:	ARNOLD
State	:	MO
Zip	:	63010-4234
Country	:	US
Telephone Number	:	636-464-1000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	02/14/2012

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