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General NPI Number Information
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NPI Number | 1568220127
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Entity Type | Individual
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Provider Name | NISMA JAVED M.B.B.S.
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Gender | Female
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Dates
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Enumeration Date | 03/08/2024
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 1201 S GRAND BLVD SSM SAINT LOUIS UNIVERSITY HOSPITAL
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City | SAINT LOUIS
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State | MO
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Zip | 63104
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Country | US
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Telephone | 314-617-2355
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Fax | 314-768-6616
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Provider Business Mailing Address
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Address Line | 1008 S SPRING AVE SLUCARE ACADEMIC PAVILION
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City | SAINT LOUIS
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State | MO
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Zip | 63110
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Country | US
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Telephone | 314-617-3137
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Fax | 314-977-3127
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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