Provider Demographics
NPI:1316390222
Name:ALEEMZAI, HASHMAT AFSAR
Entity Type:Individual
Prefix:
First Name:HASHMAT
Middle Name:AFSAR
Last Name:ALEEMZAI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4737 ALLEMANIA ST
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63116-1003
Mailing Address - Country:US
Mailing Address - Phone:314-757-3095
Mailing Address - Fax:
Practice Address - Street 1:4737 ALLEMANIA ST
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63116-1003
Practice Address - Country:US
Practice Address - Phone:314-757-3095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-15
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOLC9795093172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker