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ASM IFTIAR CHOWDHURY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
10010 KENNERLY RD, SAINT LOUIS, MO 63128-2106
(314) 525-1328
Mailing address
4230 BOTANICAL AVE, SAINT LOUIS, MO 63110-3521
(917) 963-0331

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01076775A
IN
207R00000X
Internal Medicine Physician
Primary
2019015700
MO
208M00000X
Hospitalist Physician
DR.0058623
CO

Other

Enumeration date
06/11/2013
Last updated
06/24/2020
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