Individual
FATIMA IMRAN SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD,LD
Contact information
Practice address
1015 BOWLES AVE, FENTON, MO 63026-2394
(636) 496-2543
Mailing address
1331 CULPEPPER RIDGE DR, BALLWIN, MO 63021-7526
(636) 225-1332
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2011027109
MO
Other
Enumeration date
03/26/2012
Last updated
03/26/2012
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