Provider Demographics
NPI:1326334343
Name:QUAIZAR, HUZAIFA (MD)
Entity Type:Individual
Prefix:
First Name:HUZAIFA
Middle Name:
Last Name:QUAIZAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11133 DUNN RD STE 2427
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63136-6163
Mailing Address - Country:US
Mailing Address - Phone:314-653-5643
Mailing Address - Fax:314-653-5648
Practice Address - Street 1:11133 DUNN RD
Practice Address - Street 2:STE 2427
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63136-6119
Practice Address - Country:US
Practice Address - Phone:314-653-5643
Practice Address - Fax:314-653-5648
Is Sole Proprietor?:No
Enumeration Date:2011-06-28
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MO2013017454208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program