Individual
DR. MANSOOR UL HAQ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1011 BOWLES AVE STE G50, FENTON, MO 63026-0562
(636) 496-4640
Mailing address
PO BOX 955534, SAINT LOUIS, MO 63195-5534
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
036.135192
IL
207RH0003X
Hematology & Oncology Physician
Primary
2017014864
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/28/2008
Last updated
11/12/2020
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