Individual
DR. FEDWA KHALIFA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
930 KINGSCOVE CT, CHESTERFIELD, MO 63017-8350
(314) 289-6636
(636) 778-9068
Mailing address
PO BOX 6524, CHESTERFIELD, MO 63006-6524
(314) 432-2580
(314) 432-0223
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
200200823
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14009
ESSANCE
MO
01
—
199157
BLUE CROSS BLUE SHIELD
MO
01
—
227478
GHP
MO
01
—
55895
HCUSA
MO
01
—
699445
HEALTHLINK
MO
01
—
H78529
MERCY
MO
Enumeration date
08/17/2006
Last updated
03/21/2012
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