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Individual

DR. MOHAMMAD ALI JAVED

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
12303 DE PAUL DR, BRIDGETON, MO 63044-2512
(314) 344-6000
Mailing address
1145 CORPORATE LAKE DR, SAINT LOUIS, MO 63132-2907
(314) 989-6189

Taxonomy

Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
2021031240
MO
2086S0129X
Vascular Surgery Physician
25MB09792800
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0635596
NJ
Enumeration date
10/24/2012
Last updated
08/05/2021
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