Individual
NAZEM KAISSAR BASSIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D,
Contact information
Practice address
1402 S GRAND BLVD # M238, SAINT LOUIS, MO 63104-1004
(314) 977-8462
(314) 771-8575
Mailing address
1402 S GRAND BLVD # M238, SAINT LOUIS, MO 63104-1004
(314) 977-8462
(314) 771-8575
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
2007010286
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2007010286
MO LICENSE
MO
Enumeration date
08/06/2007
Last updated
08/06/2007
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