Individual
DR. ALI AKBAR MEHDIRAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
777 S NEW BALLAS RD, SUITE 300E, SAINT LOUIS, MO 63141-8705
(314) 432-7839
(314) 432-4839
Mailing address
PO BOX 952273, SAINT LOUIS, MO 63195-2273
(314) 432-2580
(314) 432-0223
Taxonomy
Speciality
Code
Description
License number
State
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
R5G76
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
431908828
TAX ID#
MO
05
—
505207209
—
MO
01
—
CH4229
RR MEDICARE GROUP#
MO
Enumeration date
04/19/2006
Last updated
07/13/2009
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