Provider Demographics
NPI:1346862935
Name:FAZEEL, HAFIZ MUHAMMAD (MD)
Entity Type:Individual
Prefix:
First Name:HAFIZ MUHAMMAD
Middle Name:
Last Name:FAZEEL
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 1:3655 VISTA AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-2539
Mailing Address - Country:US
Mailing Address - Phone:314-257-8228
Mailing Address - Fax:314-257-8221
Practice Address - Street 1:3655 VISTA AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-2539
Practice Address - Country:US
Practice Address - Phone:314-257-8228
Practice Address - Fax:314-257-8221
Is Sole Proprietor?:No
Enumeration Date:2020-05-18
Last Update Date:2023-07-07
Deactivation Date:2022-01-17
Deactivation Code:
Reactivation Date:2022-06-27
Provider Licenses
StateLicense IDTaxonomies
MO2023026675208M00000X
MO000000207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist