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Individual

DR. BASSAM AR HADI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
10012 KENNERLY RD STE 400, SAINT LOUIS, MO 63128-2197
(314) 543-5999
Mailing address
1050 W 10TH ST, ROLLA, MO 65401-2905
(573) 364-9000
(573) 426-2108

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
2003009742
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000525779
BLUECROSS
KY
05
200316690A
OK
05
64016272
KY
05
6401627200
KY
01
P00732227
MEDICARE PTAN
KY
Enumeration date
07/11/2006
Last updated
02/05/2026
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