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General NPI Number Information
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NPI Number | 1366162703
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Entity Type | Individual
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Provider Name | ABDALLAH FAREED DWEEKAT MD
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Gender | Male
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Dates
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Enumeration Date | 08/29/2022
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Last Update Date | 04/11/2025
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Provider Practice Location Address
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Address Line | 1201 S GRAND BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63104-1016
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Country | US
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Telephone | 314-257-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 1270 W 70TH ST APT 336
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City | CLEVELAND
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State | OH
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Zip | 44102-2317
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Country | US
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Telephone | 216-681-5500
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Fax | 216-363-7490
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 2025012043
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2025012043
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 57.253048
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License Number State | OH
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