Healthcare Provider Details

I. General information

NPI: 1508480666
Provider Name (Legal Business Name): AMER HUSSEIN ABBAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2020
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11125 DUNN RD STE 204
SAINT LOUIS MO
63136-6188
US

IV. Provider business mailing address

11125 DUNN RD STE 204
SAINT LOUIS MO
63136-6188
US

V. Phone/Fax

Practice location:
  • Phone: 636-625-2662
  • Fax: 636-625-1644
Mailing address:
  • Phone: 636-625-2662
  • Fax: 636-625-1644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2026028924
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: