Individual
DR. SARFARAZ A JASDANWALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4066 DUNNICA AVE, SAINT LOUIS, MO 63116-3510
(636) 224-1700
Mailing address
1003 HAUCK DR, ROLLA, MO 65401-2584
(573) 466-2056
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
190524
CA
207R00000X
Internal Medicine Physician
2015021629
MO
207R00000X
Internal Medicine Physician
4301503408
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036.162657
STATE LICENSE
IL
01
—
2015021629
STATE LICENSE
MO
01
—
2500025774
CDS
MO
01
—
336.120566
LICENSED PHYSICIAN CONTROLLED SUBSTANCE
IL
01
—
C190524
STATE LICENSE
CA
Enumeration date
07/17/2012
Last updated
04/20/2026
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