# SYED SHAHID MUMTAZ MD

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CHESTERFIELD VALLEY PSYCHIATRY
- **Other names:** Chesterfield Valley Psychiatry
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1225587272
- **Legal business name:** CHESTERFIELD VALLEY PSYCHIATRY
- **Authorized official:** DR. SYED SHAHID MUMTAZ MD (OWNER)
- **Authorized official phone:** (636) 519-7404

## Contact information

- **Practice address:** 17269 WILD HORSE CREEK RD, \#250, CHESTERFIELD, MO 63005-1360
- **Practice address phone:** (636) 519-7404
- **Practice address fax:** (636) 537-0043
- **Mailing address:** 17269 WILD HORSE CREEK RD, \#250, CHESTERFIELD, MO 63005-1360
- **Mailing address phone:** (636) 519-7404
- **Mailing address fax:** (636) 537-0043

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084P0804X | Child & Adolescent Psychiatry Physician | MD114459 | MO | Yes |

## Other

- **Enumeration date:** 09/30/2016
- **Last updated:** 09/30/2016