Healthcare Provider Details

I. General information

NPI: 1225009384
Provider Name (Legal Business Name): RAFAT NASHED ORTHOPEDICS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2006
Last Update Date: 06/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2865 NETHERTON DR
SAINT LOUIS MO
63136-4674
US

IV. Provider business mailing address

PO BOX 1209
MARYLAND HEIGHTS MO
63043-0209
US

V. Phone/Fax

Practice location:
  • Phone: 314-355-6070
  • Fax:
Mailing address:
  • Phone: 314-989-0300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number104163
License Number StateMO

VIII. Authorized Official

Name: RAFAT NASHED
Title or Position: OWNER
Credential: MD
Phone: 314-355-6070