Individual
DR. TAHA MOHAMED DJIRDEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4921 PARKVIEW PL, DIV IM NEPHROLOGY, STE 5C, SAINT LOUIS, MO 63110-1032
(314) 362-7603
(314) 362-5470
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 362-7603
(314) 362-5470
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2024012035
MO
207RN0300X
Nephrology Physician
Primary
2024012035
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200115752
—
MO
Enumeration date
07/21/2019
Last updated
04/17/2025
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