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General NPI Number Information
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NPI Number | 1316908155
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Entity Type | Individual
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Provider Name | NABIL AHMAD M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/31/2006
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Last Update Date | 03/15/2021
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Provider Practice Location Address
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Address Line | 12855 N 40 DR STE 275
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City | SAINT LOUIS
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State | MO
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Zip | 63141-8667
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Country | US
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Telephone | 314-395-7699
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Fax | 314-878-7882
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Provider Business Mailing Address
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Address Line | PO BOX 412024 SUITE NUMBER 120
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City | CREVE COEUR
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State | MO
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Zip | 63141-2024
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Country | US
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Telephone | 314-395-7699
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Fax | 314-878-7882
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | 2001024923
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 2001024923
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License Number State | MO
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