Individual
BASIL ISAM SHAHIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10010 KENNERLY RD, SAINT LOUIS, MO 63128-2106
(314) 525-1328
Mailing address
10010 KENNERLY RD, SAINT LOUIS, MO 63128-2106
(314) 525-1328
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2022028832
MO
207R00000X
Internal Medicine Physician
Primary
25MA11819300
NJ
207R00000X
Internal Medicine Physician
MT219012
PA
Other
Enumeration date
06/20/2019
Last updated
12/08/2023
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