Individual
AZAM KHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
615 S NEW BALLAS RD, SAINT LOUIS, MO 63141-8221
(314) 509-5305
Mailing address
615 S NEW BALLAS RD, SAINT LOUIS, MO 63141-8221
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2019019100
MO
Other
Enumeration date
06/10/2019
Last updated
06/10/2019
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