Provider Demographics
NPI:1043611767
Name:M SERAJI MD LLC
Entity Type:Organization
Organization Name:M SERAJI MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:MEHRZAD
Authorized Official - Middle Name:
Authorized Official - Last Name:SERAJI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-985-8035
Mailing Address - Street 1:1040 N MASON RD STE 201
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-6366
Mailing Address - Country:US
Mailing Address - Phone:314-985-8035
Mailing Address - Fax:314-985-8034
Practice Address - Street 1:1040 N MASON RD STE 201
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-6366
Practice Address - Country:US
Practice Address - Phone:314-985-8035
Practice Address - Fax:314-985-8034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-12
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty