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General NPI Number Information
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NPI Number | 1306703038
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Entity Type | Organization
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Legal Business Name | METRO MEDICAL NORTH COUNTY LLC
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Dates
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Enumeration Date | 01/06/2026
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 11115 NEW HALLS FERRY RD STE 105
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City | FLORISSANT
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State | MO
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Zip | 63033-7610
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Country | US
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Telephone | 314-921-6200
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Fax | 314-830-0756
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Provider Business Mailing Address
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Address Line | 11115 NEW HALLS FERRY RD STE 105
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City | FLORISSANT
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State | MO
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Zip | 63033-7610
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Country | US
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Telephone | 314-921-6200
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Fax | 314-830-0756
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Authorized Official
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Title or Position | OWNER
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Name | JAWED H SIDDIQUI
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Credential |
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Telephone | 314-921-6200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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