Healthcare Provider Details

I. General information

NPI: 1578481248
Provider Name (Legal Business Name): FAIZAN MASOOD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOSPITAL DR
COLUMBIA MO
65212-1000
US

IV. Provider business mailing address

501 TURNER AVE APT 1
COLUMBIA MO
65201-4135
US

V. Phone/Fax

Practice location:
  • Phone: 573-884-1606
  • Fax:
Mailing address:
  • Phone: 413-304-9568
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number2026026057
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: