MEDICARE: DR. USMAN QAYYUM 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	207RC0000X	Cardiovascular Disease Physician	2003007575	MO
2	207RI0011X	Interventional Cardiology Physician	2003007575	MO
3	207RC0000X	Cardiovascular Disease Physician	036100225	IL
4	207RI0011X	Interventional Cardiology Physician	036100225	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992728000
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. USMAN QAYYUM M.D.

Provider Business Mailing Address
First Line	:	11155 DUNN RD STE 304E
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63136-6111
Country	:	US
Telephone Number	:	314-741-0911
Fax Number	:	314-741-0501

Provider Business Practice Location Address
First Line	:	11155 DUNN RD
Second Line	:	SUITE 304E
City	:	SAINT LOUIS
State	:	MO
Zip	:	63136-6150
Country	:	US
Telephone Number	:	314-741-0911
Fax Number	:	314-741-0501

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

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	04/19/2026

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Directions to “ DR. USMAN QAYYUM M.D.” Practice Location

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