Individual
DR. MOHAMMAD F GHANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3915 WATSON RD, SUITE # 101, SAINT LOUIS, MO 63109-1251
(314) 644-5300
(314) 644-5308
Mailing address
PO BOX 240106, BALLWIN, MO 63024-0106
(314) 644-5300
(314) 644-5308
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
R4716
MO
207RC0000X
Cardiovascular Disease Physician
Primary
R4716
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200761310
—
MO
01
—
P00392848
RR MEDICARE
MO
01
—
P00395464
RR MEDICARE
MO
Enumeration date
05/10/2006
Last updated
03/02/2011
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