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FAREESA KHAN LLC NPI 1780923490


NPI Information

NPI: 1780923490
Provider Name: FAREESA KHAN LLC
Classification: Obstetrics & Gynecology - 207VF0040X
Entity Type: Organization

Specialization: Female Pelvic Medicine and Reconstructive Surgery

Address:
10004 KENNERLY RD STE 255A
SAINT LOUIS, MO
ZIP 63128
Phone: (314) 270-9880
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FAREESA KHAN LLC is a female pelvic medicine and reconstructive surgery obstetrics gynecology in Saint Louis, MO. The provider is a subspecialist in Female Pelvic Medicine and Reconstructive Surgery is a physician in Urology or Obstetrics and Gynecology who, by virtue of education and training, is prepared to provide consultation and comprehensive management of women with complex benign pelvic conditions, lower urinary tract disorders, and pelvic floor dysfunction. Comprehensive management includes those diagnostic and therapeutic procedures necessary for the total care of the patient with these conditions and complications resulting from them. FAREESA KHAN LLC NPI is 1780923490. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

10004 KENNERLY RD STE 255A
SAINT LOUIS, MO
ZIP 63128-184
Phone: (314) 270-9880

The provider's authorized official is Fareesa G Khan .
The authorized official title is Owner and has the following contact phone number (636) 675-3107.

The enumeration date for this NPI number is 2/1/2013 and was last updated on 7/10/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207VF0040XObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive Surgery112917MISSOURIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1203820014MEDICAIDMISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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