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General NPI Number Information
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NPI Number | 1811572068
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Entity Type | Organization
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Legal Business Name | HEALTH ALLY M.D., LLC
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Dates
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Enumeration Date | 03/09/2021
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Last Update Date | 10/18/2022
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Provider Practice Location Address
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Address Line | 49 BRIGHTON WAY
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City | SAINT LOUIS
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State | MO
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Zip | 63105-1682
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Country | US
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Telephone | 888-236-1878
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Fax |
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Provider Business Mailing Address
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Address Line | 7750 MARYLAND AVE UNIT 11772
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City | SAINT LOUIS
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State | MO
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Zip | 63105-5525
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ORGANIZER
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Name | ANNIE NGUYEN
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Credential | MD
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Telephone | 408-858-4687
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207QB0002X
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Taxonomy Name | Obesity Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207QS1201X
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Taxonomy Name | Sleep Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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