Fareesa Khan LLC
Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery in Saint Louis, MO. Organization (NPI-2).
NPI number1780923490
StatusActive
Last updated in NPPESJul 10, 2020
Details
- NPI
- 1780923490
- Entity type
- Organization (NPI-2)
- Legal business name
- Fareesa Khan LLC
- Organization subpart
- No
- Enumeration date
- Feb 1, 2013
- Certification date
- Jul 10, 2020
- Last updated
- Jul 10, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207VF0040X | Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery | 112917 | MO | Yes |
Practice location
10004 Kennerly Rd Ste 255aSaint Louis, MO 63128-2184
Phone 314-270-9880
Mailing address
Po Box 410085Saint Louis, MO 63141-0085
Phone 636-675-3107
Authorized official
Fareesa G Khan
Owner
6366753107
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