Healthcare Provider Details

I. General information

NPI: 1235455866
Provider Name (Legal Business Name): ANMAAR M GAZAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ANMAAR M NABI-ABDUL MD

II. Dates (important events)

Enumeration Date: 04/07/2010
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10010 KENNERLY RD
SAINT LOUIS MO
63128-2106
US

IV. Provider business mailing address

1650 PRAIRIE CORD DR
CHESTERFIELD MO
63005-4337
US

V. Phone/Fax

Practice location:
  • Phone: 314-525-1000
  • Fax:
Mailing address:
  • Phone: 314-525-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number2015008173
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: