Individual
RANDA IBRAHIM HAZAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1201 S GRAND BLVD, SAINT LOUIS, MO 63104-1016
(314) 257-8222
Mailing address
1201 S GRAND BLVD, SAINT LOUIS, MO 63104-1016
(314) 257-8222
(806) 354-5717
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2022040465
MO
208M00000X
Hospitalist Physician
202204065
MO
Other
Enumeration date
04/13/2018
Last updated
11/01/2022
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