Provider Demographics
NPI:1437363553
Name:SAWAF-HAJJI, RANDA (MD)
Entity Type:Individual
Prefix:
First Name:RANDA
Middle Name:
Last Name:SAWAF-HAJJI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RANDA
Other - Middle Name:
Other - Last Name:SAWAF
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:12255 DE PAUL DR
Mailing Address - Street 2:SUITE 600
Mailing Address - City:BRIDGETON
Mailing Address - State:MO
Mailing Address - Zip Code:63044-2510
Mailing Address - Country:US
Mailing Address - Phone:314-209-5100
Mailing Address - Fax:314-209-5152
Practice Address - Street 1:12255 DE PAUL DR
Practice Address - Street 2:SUITE 600
Practice Address - City:BRIDGETON
Practice Address - State:MO
Practice Address - Zip Code:63044-2510
Practice Address - Country:US
Practice Address - Phone:314-209-5100
Practice Address - Fax:314-209-5152
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004033970207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine