MEDICARE: MOHAMAD AL-HOSNI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080N0001X	Neonatal-Perinatal Medicine Physician	113308	MO
2	208000000X	Pediatrics Physician	113308	MO

General Provider Information

NPI Number	:	1053351338
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOHAMAD AL-HOSNI M.D.

Provider Business Mailing Address
First Line	:	14443 WHITE BIRCH VALLEY LN
Second Line	:
City	:	CHESTERFIELD
State	:	MO
Zip	:	63017-2415
Country	:	US
Telephone Number	:	314-629-5671
Fax Number	:

Provider Business Practice Location Address
First Line	:	14443 WHITE BIRCH VALLEY LN
Second Line	:
City	:	CHESTERFIELD
State	:	MO
Zip	:	63017-2415
Country	:	US
Telephone Number	:	314-629-5671
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	10/14/2020

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