Healthcare Provider Details

I. General information

NPI: 1144925967
Provider Name (Legal Business Name): ALI BASIL ALSHAWI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: ALI BASIL ALI MD

II. Dates (important events)

Enumeration Date: 04/03/2023
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BARNES PLAZA
SAINT LOUIS MO
63110-1003
US

IV. Provider business mailing address

43259 HERRING DR
CLINTON TWP MI
48038-4447
US

V. Phone/Fax

Practice location:
  • Phone: 314-363-1299
  • Fax:
Mailing address:
  • Phone: 586-928-3116
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number2025024878
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: