Individual
NIMROD SHABTAI BARASHI GOZAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
111 SAINT LUKES CENTER DR STE 24B, CHESTERFIELD, MO 63017-3509
(636) 685-7830
(314) 590-5971
Mailing address
445 E OHIO ST APT 1703, CHICAGO, IL 60611-4685
(312) 989-5017
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
2024000198
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200094624
—
MO
Enumeration date
03/31/2018
Last updated
06/04/2024
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