Individual
DR. AHMED M EL-SABBAGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1402 S GRAND BLVD, DIVISION OF NUCLEAR MEDICINE, FDT-2, SAINT LOUIS, MO 63104-1004
(314) 577-8047
Mailing address
1402 S GRAND BLVD, DIVISION OF NUCLEAR MEDICINE, FDT-2, SAINT LOUIS, MO 63104-1004
(314) 577-8047
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
4301104848
MI
207UN0902X
Nuclear Imaging & Therapy Physician
2015018271
MO
2085R0202X
Diagnostic Radiology Physician
4301104848
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2015018271
MISSOURI LICCENSE
MO
01
—
4301104848
PHYSICIAN LICENCE
MI
Enumeration date
11/23/2015
Last updated
03/06/2024
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