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Individual

DR. AHMED KHAMIS BAMAGA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D, FRCPC,

Contact information

Practice address
660 S EUCLID AVE, COMPUS BOX 8111, SAINT LOUIS, MO 63110-1010
(314) 362-6981
Mailing address
660 S EUCLID AVE, COMPUS BOX 8111, SAINT LOUIS, MO 63110-1010
(314) 362-6981

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
2016011080
MO
390200000X
Student in an Organized Health Care Education/Training Program
Primary
2016011080
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2016011080
MISSOURI LICENSE
MO
Enumeration date
09/19/2016
Last updated
09/19/2016
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