Healthcare Provider Details

I. General information

NPI: 1447912340
Provider Name (Legal Business Name): ANAS MALIK ALRWASHDEH M.B.B.S
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2021
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 S GRAND BLVD
SAINT LOUIS MO
63104-1016
US

IV. Provider business mailing address

4601 W MARKHAM ST APT 4231
LITTLE ROCK AR
72205-3874
US

V. Phone/Fax

Practice location:
  • Phone: 314-617-2000
  • Fax:
Mailing address:
  • Phone: 501-502-7679
  • Fax: 501-200-9418

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number2026022000
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: