Individual
FNU EHTISHAM-UL HAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6420 CLAYTON RD ST. MARY'S HOSPITAL-ST. LOUIS, DEPT OF INTERNAL MEDICINE 2ND FLOOR, ST. LOUIS, MO 63117
(314) 768-8778
(314) 768-7101
Mailing address
6420 CLAYTON RD ST. MARY'S HOSPITAL-ST. LOUIS, DEPT OF INTERNAL MEDICINE 2ND FLOOR, ST. LOUIS, MO 63117
(314) 768-8778
(314) 768-7101
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
2025024125
MO
Other
Enumeration date
08/26/2025
Last updated
04/02/2026
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