MEDICARE: ATHEEL ALSAGHEER MD

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	2085R0202X	Diagnostic Radiology Physician	86060	WI
2	208D00000X	General Practice Physician	2022024316	MO
3	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1558007666
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ATHEEL ALSAGHEER MD

Provider Business Mailing Address
First Line	:	915 N GRAND BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63106-1621
Country	:	US
Telephone Number	:	443-559-2936
Fax Number	:

Provider Business Practice Location Address
First Line	:	1402 S GRAND BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63104-1004
Country	:	US
Telephone Number	:	314-977-4289
Fax Number	:	314-977-1628

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

Provider Enumeration Date	:	05/11/2022
Last Update Date	:	12/10/2025

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Directions to “ ATHEEL ALSAGHEER MD” Practice Location

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