Healthcare Provider Details

I. General information

NPI: 1164337424
Provider Name (Legal Business Name): UNKNOWN NOOR UL AIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NOOR UL AIN MD

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOSPITAL DR
COLUMBIA MO
65212-1000
US

IV. Provider business mailing address

1021 ASHLAND RD
COLUMBIA MO
65201-7595
US

V. Phone/Fax

Practice location:
  • Phone: 573-884-1255
  • Fax:
Mailing address:
  • Phone: 314-703-9819
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number2026020490
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: