Organization
KSJ MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KHALED JUMEAN MD (OWNER)
(201) 407-3489
Entity
Organization
Contact information
Practice address
300 1ST CAPITOL DR, SAINT CHARLES, MO 63301-2844
(636) 947-5000
(636) 333-4510
Mailing address
23 TODDINGTON TER, SAINT LOUIS, MO 63128-2632
(201) 407-3489
(636) 333-4510
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
208M00000X
Hospitalist Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447849575
—
IL
05
—
500093947
—
MO
Enumeration date
01/13/2021
Last updated
03/15/2026
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