Healthcare Provider Details

I. General information

NPI: 1396182242
Provider Name (Legal Business Name): FOUAD FATHI EL SAYYAD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2013
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4921 PARKVIEW PL
SAINT LOUIS MO
63110-1032
US

IV. Provider business mailing address

660 S EUCLID AVE # 8096
SAINT LOUIS MO
63110-1010
US

V. Phone/Fax

Practice location:
  • Phone: 314-362-3937
  • Fax: 314-362-3725
Mailing address:
  • Phone: 314-747-5380
  • Fax: 314-362-5590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberTRN19098
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number2017022831
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: