Provider Demographics
NPI:1134319510
Name:NAWAS, HUSAM T (MD)
Entity Type:Individual
Prefix:
First Name:HUSAM
Middle Name:T
Last Name:NAWAS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:12813 FLUSHING MEADOWS DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-1835
Mailing Address - Country:US
Mailing Address - Phone:314-966-0111
Mailing Address - Fax:314-966-2810
Practice Address - Street 1:12855 NORTH FORTY DRIVE
Practice Address - Street 2:SUITE 125, NORTH TOWER
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141
Practice Address - Country:US
Practice Address - Phone:314-966-0111
Practice Address - Fax:314-966-2810
Is Sole Proprietor?:No
Enumeration Date:2007-07-31
Last Update Date:2011-11-17
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Provider Licenses
StateLicense IDTaxonomies
MO2011005780207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine