Provider Demographics
NPI:1619196367
Name:ALI, SAMREEN MEHAR (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMREEN
Middle Name:MEHAR
Last Name:ALI
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:222 S WOODS MILL RD
Mailing Address - Street 2:SUITE # 750 NORTH
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-3625
Mailing Address - Country:US
Mailing Address - Phone:314-205-6050
Mailing Address - Fax:
Practice Address - Street 1:5701 DELMAR BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63112-2617
Practice Address - Country:US
Practice Address - Phone:314-367-7848
Practice Address - Fax:314-367-6588
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2014-05-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO117554207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOH41209Medicare UPIN