Individual
FOURUTAN TIM SHAFIEI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 BARNES JEWISH HOSPITAL PLZ, DEPT ANESTHESIOLOGY, SAINT LOUIS, MO 63110-1003
(800) 862-9980
(314) 362-1185
Mailing address
660 S EUCLID AVE, CB 8054, SAINT LOUIS, MO 63110-1010
(800) 862-9980
(314) 362-1185
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036155333
IL
207L00000X
Anesthesiology Physician
2019024578
MO
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
2019024578
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200089048
—
MO
Enumeration date
05/08/2015
Last updated
11/02/2022
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