Individual
MAFAZA KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
615 S NEW BALLAS RD, SAINT LOUIS, MO 63141-8221
(314) 251-6339
Mailing address
621 S NEW BALLAS RD STE 112A, SAINT LOUIS, MO 63141-8252
(314) 251-6339
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2023010200
MO
Other
Enumeration date
03/30/2020
Last updated
09/11/2023
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