Healthcare Provider Details

I. General information

NPI: 1316170111
Provider Name (Legal Business Name): ZAFAR AKRAM JAMKHANA M.D., M.P.H.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2009
Last Update Date: 07/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1402 S GRAND BLVD MC / SLUH / 7 FDT
SAINT LOUIS MO
63104-1004
US

IV. Provider business mailing address

1402 S GRAND BLVD MC / SLUH / 7 FDT
SAINT LOUIS MO
63104-1004
US

V. Phone/Fax

Practice location:
  • Phone: 314-577-8856
  • Fax: 314-577-8859
Mailing address:
  • Phone: 314-577-8856
  • Fax: 314-577-8859

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number2012008175
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: