Individual
TANVIRA K ALAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1101 HIGHWAY K, O FALLON, MO 63366-8431
(636) 379-6363
Mailing address
PO BOX 955534, SAINT LOUIS, MO 63195-5534
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
2012028275
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/25/2009
Last updated
11/23/2020
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