Healthcare Provider Details

I. General information

NPI: 1780728337
Provider Name (Legal Business Name): PARVEEN AHMED MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/16/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3015 N BALLAS RD DEPARTMENT OF PATHOLOGY
SAINT LOUIS MO
63131-2329
US

IV. Provider business mailing address

PO BOX 500720
SAINT LOUIS MO
63150-0720
US

V. Phone/Fax

Practice location:
  • Phone: 314-996-5453
  • Fax: 314-996-5551
Mailing address:
  • Phone: 314-989-0300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number36224
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: