Healthcare Provider Details

I. General information

NPI: 1609970102
Provider Name (Legal Business Name): HELAL EKRAMUDDIN, M.D.,L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 07/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2870 NETHERTON DR
SAINT LOUIS MO
63136-4649
US

IV. Provider business mailing address

PO BOX 797054
SAINT LOUIS MO
63179-7000
US

V. Phone/Fax

Practice location:
  • Phone: 314-355-2700
  • Fax: 314-355-2720
Mailing address:
  • Phone: 314-878-0163
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number2001014922
License Number StateMO

VIII. Authorized Official

Name: DR. HELAL EKRAMUDDIN
Title or Position: PHYSICIAN AND SURGEON
Credential: M.D.
Phone: 314-355-2700