Individual
ALI AL BALUSHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3660 VISTA AVE, SUITE 303, SAINT LOUIS, MO 63110-2540
(314) 977-6082
(314) 977-6086
Mailing address
1438 S GRAND BLVD, SAINT LOUIS, MO 63104-1027
(314) 977-4800
(314) 977-4876
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
2014016456
MO
Other
Enumeration date
08/04/2014
Last updated
08/04/2014
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