Healthcare Provider Details

I. General information

NPI: 1063235109
Provider Name (Legal Business Name): MUHAMMAD NADEEM SOHAIL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2024
Last Update Date: 11/06/2024
Certification Date: 11/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 S GRAND BLVD
SAINT LOUIS MO
63104-1016
US

IV. Provider business mailing address

900 S SARAH ST APT 203
SAINT LOUIS MO
63110-1796
US

V. Phone/Fax

Practice location:
  • Phone: 314-617-2359
  • Fax: 314-617-2534
Mailing address:
  • Phone: 314-326-5004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: