MEDICARE: AJUMA KALEEM MUHAMMAD L.P.C.

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	101YP2500X	Professional Counselor	001709	MO

General Provider Information

NPI Number	:	1851519409
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AJUMA KALEEM MUHAMMAD L.P.C.

Provider Business Mailing Address
First Line	:	12052 CATO DR.
Second Line	:
City	:	ST. LOUIS
State	:	MO
Zip	:	63033
Country	:	US
Telephone Number	:	314-249-1061
Fax Number	:	314-838-3096

Provider Business Practice Location Address
First Line	:	12052 CATO DR.
Second Line	:
City	:	ST. LOUIS
State	:	MO
Zip	:	63033
Country	:	US
Telephone Number	:	314-249-1061
Fax Number	:	314-838-3096

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

Provider Enumeration Date	:	04/20/2007
Last Update Date	:	07/08/2007

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