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General NPI Number Information
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NPI Number | 1376917781
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Entity Type | Individual
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Provider Name | AHMED M EL-SABBAGH M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/23/2015
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Last Update Date | 03/06/2024
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Provider Practice Location Address
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Address Line | 1402 S GRAND BLVD DIVISION OF NUCLEAR MEDICINE, FDT-2
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City | SAINT LOUIS
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State | MO
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Zip | 63104-1004
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Country | US
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Telephone | 314-577-8047
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Fax |
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Provider Business Mailing Address
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Address Line | 1402 S GRAND BLVD DIVISION OF NUCLEAR MEDICINE, FDT-2
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City | SAINT LOUIS
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State | MO
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Zip | 63104-1004
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Country | US
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Telephone | 314-577-8047
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Fax |
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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 | 207UN0902X
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Taxonomy Name | Nuclear Imaging & Therapy Physician
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License Number | 2015018271
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 4301104848
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 4301104848
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License Number State | MI
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