Individual
DR. ASHFAQ ULLAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12255 DE PAUL DR STE 500, BRIDGETON, MO 63044-2515
(314) 209-5180
Mailing address
PO BOX 955534, SAINT LOUIS, MO 63195-5534
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036149154
IL
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
246095
MA
207RP1001X
Pulmonary Disease Physician
036149154
IL
207RP1001X
Pulmonary Disease Physician
2018003079
MO
207RP1001X
Pulmonary Disease Physician
246095
MA
208M00000X
Hospitalist Physician
246095
MA
Other
Enumeration date
06/19/2008
Last updated
07/15/2021
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