Healthcare Provider Details

I. General information

NPI: 1316908155
Provider Name (Legal Business Name): NABIL AHMAD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 S NEW BALLAS RD STE 320
SAINT LOUIS MO
63141-8725
US

IV. Provider business mailing address

701 S NEW BALLAS RD STE 320
SAINT LOUIS MO
63141-8725
US

V. Phone/Fax

Practice location:
  • Phone: 314-251-7888
  • Fax: 314-251-7887
Mailing address:
  • Phone: 314-251-7888
  • Fax: 314-251-7887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number2001024923
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: