Individual
MOHAMED FAWZI MUDARRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
615 S NEW BALLAS RD, SAINT LOUIS, MO 63141-8221
(314) 251-6000
Mailing address
420 5TH ST APT 16, CORALVILLE, IA 52241-3422
(319) 471-7629
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2025020148
MO
207RN0300X
Nephrology Physician
R-12809
IA
Other
Enumeration date
10/04/2023
Last updated
06/17/2025
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