Provider Demographics
NPI:1053845321
Name:MASUD, ABDULLAH AL (MD)
Entity Type:Individual
Prefix:
First Name:ABDULLAH
Middle Name:AL
Last Name:MASUD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1008 SOUTH SPRING
Mailing Address - Street 2:GIM, 2ND FLOOR
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-2520
Mailing Address - Country:US
Mailing Address - Phone:314-257-8222
Mailing Address - Fax:314-577-8019
Practice Address - Street 1:1201 S GRAND BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63104-1016
Practice Address - Country:US
Practice Address - Phone:314-257-8222
Practice Address - Fax:314-577-8019
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-13
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2020023585208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1053845321OtherNPI