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General NPI Number Information
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NPI Number | 1295722445
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Entity Type | Organization
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Legal Business Name | ALLERGY & ASTHMA SPECIALISTS PC
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Dates
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Enumeration Date | 10/03/2005
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Last Update Date | 01/21/2010
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Provider Practice Location Address
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Address Line | 4200 N CLOVERLEAF DR SUITE G
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City | SAINT PETERS
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State | MO
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Zip | 63376-6436
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Country | US
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Telephone | 636-928-1232
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Fax |
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Provider Business Mailing Address
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Address Line | 10, CONWAY SPRINGS DRIVE
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City | CHESTERFIELD
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State | MO
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Zip | 63017-3411
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Country | US
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Telephone | 636-928-1232
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MOHAMMAD H. RAHMAN
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Credential | MD
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Telephone | 636-828-1232
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207KA0200X
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Taxonomy Name | Allergy Physician
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License Number | 34881
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License Number State | MO
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