Healthcare Provider Details

I. General information

NPI: 1639144785
Provider Name (Legal Business Name): NAMAN A GHAZAL-ALBAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5551 WINGHAVEN BLVD SUITE 260
O FALLON MO
63368-3617
US

IV. Provider business mailing address

PO BOX 652
CHESTERFIELD MO
63006-0652
US

V. Phone/Fax

Practice location:
  • Phone: 636-200-3811
  • Fax: 636-200-3812
Mailing address:
  • Phone: 314-432-2580
  • Fax: 314-432-0223

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number109210
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number109210
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number109210
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: