Individual
MS. RUKHSAAR KHANAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MBBS
Contact information
Practice address
615 S NEW BALLAS RD, SAINT LOUIS, MO 63141
(314) 251-6000
Mailing address
12958 AMBOIS DRIVE, SAINT LOUIS, MO 63141
(518) 986-5141
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
2023001521
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/30/2020
Last updated
06/28/2023
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