Healthcare Provider Details

I. General information

NPI: 1649880386
Provider Name (Legal Business Name): MARAM MUNEER SAYEL ALKHDOUR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2020
Last Update Date: 07/24/2023
Certification Date: 07/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WUSM PEDS, 1 CHILDRENS PL, MSC 8116-0043-09
ST LOUIS MO
63110
US

IV. Provider business mailing address

WUSM PEDS, 1 CHILDRENS PL, MSC 8116-0043-09
ST LOUIS MO
63110
US

V. Phone/Fax

Practice location:
  • Phone: 314-454-6051
  • Fax: 314-454-6225
Mailing address:
  • Phone: 314-454-6051
  • Fax: 314-454-6225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2023027310
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: