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Individual

DR. MOHAMMAD MITHAL VAKASSI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6406 WISE AVE, SAINT LOUIS, MO 63139-3315
(618) 346-1111
(618) 346-7777
Mailing address
6406 WISE AVE, SAINT LOUIS, MO 63139-3315
(618) 346-1111
(618) 346-7777

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
036058818
IL
207RC0000X
Cardiovascular Disease Physician
Primary
35561
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1184602096
IL
Enumeration date
01/03/2006
Last updated
11/18/2024
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