Healthcare Provider Details

I. General information

NPI: 1952816639
Provider Name (Legal Business Name): DIGESTIVE HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2017
Last Update Date: 02/23/2022
Certification Date: 02/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2870 NETHERTON DR
SAINT LOUIS MO
63136-4649
US

IV. Provider business mailing address

1772 STIFEL LANE DR
CHESTERFIELD MO
63017-8047
US

V. Phone/Fax

Practice location:
  • Phone: 314-529-0661
  • Fax: 314-529-0867
Mailing address:
  • Phone: 314-439-5993
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: TARIQ HASSAN
Title or Position: PHYSICIAN OWNER
Credential: MD
Phone: 314-529-0661