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General NPI Number Information
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NPI Number | 1801414289
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Entity Type | Individual
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Provider Name | SHAH TAHA SARMAST MD
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Gender | Male
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Dates
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Enumeration Date | 07/11/2020
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | 120 BOYD ST
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City | DE SOTO
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State | MO
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Zip | 63020-1702
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Country | US
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Telephone | 636-282-0380
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Fax |
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Provider Business Mailing Address
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Address Line | 1153 E GANNON DR
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City | FESTUS
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State | MO
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Zip | 63028-2611
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Country | US
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Telephone | 636-282-0380
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Fax | 877-592-0806
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2025042061
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License Number State | MO
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