Individual
BUSHRA AJAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSCCC-A
Contact information
Practice address
3860 S LINDBERGH BLVD STE 108, SAINT LOUIS, MO 63127-1373
(314) 729-0077
(314) 729-0101
Mailing address
3860 S LINDBERGH BLVD STE 108, SAINT LOUIS, MO 63127-1373
(314) 729-0077
(314) 729-0101
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
2002008810
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2002008810
LICENSE NUMBER
MO
Enumeration date
12/29/2009
Last updated
12/29/2009
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