Healthcare Provider Details

I. General information

NPI: 1003962820
Provider Name (Legal Business Name): SUMERA YOUNUS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS SUMERA KHAYAL

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3009 N BALLAS RD STE 387C
SAINT LOUIS MO
63131-2324
US

IV. Provider business mailing address

660 MASON RIDGE CENTER DR STE 300
SAINT LOUIS MO
63141-8512
US

V. Phone/Fax

Practice location:
  • Phone: 314-996-5900
  • Fax:
Mailing address:
  • Phone: 314-996-5772
  • Fax: 314-996-7691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301082145
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number2008004486
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2008004486
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: