Healthcare Provider Details

I. General information

NPI: 1841986247
Provider Name (Legal Business Name): SARA MICHELLE MAJIDIAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2023
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 S GRAND BLVD
SAINT LOUIS MO
63104-1016
US

IV. Provider business mailing address

3691 RUTGER ST
SAINT LOUIS MO
63110-2515
US

V. Phone/Fax

Practice location:
  • Phone: 314-617-3749
  • Fax:
Mailing address:
  • Phone: 314-617-3749
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA207639
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: