Individual
DR. SELASI MABONGA NAKHAIMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10010 KENNERLY RD, SAINT LOUIS, MO 63128-2106
(314) 525-1165
Mailing address
11475 OLDE CABIN RD STE 200, SAINT LOUIS, MO 63141-7129
(314) 991-8200
(314) 569-1787
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
2019045772
MO
2085R0202X
Diagnostic Radiology Physician
43209
OK
Other
Enumeration date
03/19/2018
Last updated
07/16/2024
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