MEDICARE: MR. ZIA IQBAL

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	172A00000X	Driver	T149125004	MO

General Provider Information

NPI Number	:	1578014254
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ZIA IQBAL

Provider Business Mailing Address
First Line	:	18118 CHESTERFIELD AIRPORT RD
Second Line	:	SUITE N
City	:	CHESTERFIELD
State	:	MO
Zip	:	63005-1124
Country	:	US
Telephone Number	:	314-757-7244
Fax Number	:

Provider Business Practice Location Address
First Line	:	18118 CHESTERFIELD AIRPORT RD
Second Line	:	SUITE N
City	:	CHESTERFIELD
State	:	MO
Zip	:	63005-1124
Country	:	US
Telephone Number	:	314-757-7244
Fax Number	:

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

Provider Enumeration Date	:	10/18/2016
Last Update Date	:	10/18/2016

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Directions to “ MR. ZIA IQBAL ” Practice Location

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