Provider Demographics
NPI:1740399724
Name:IQBAL, SHERIFA FATIMA (MD)
Entity Type:Individual
Prefix:DR
First Name:SHERIFA
Middle Name:FATIMA
Last Name:IQBAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MISSY
Other - Middle Name:
Other - Last Name:IQBAL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:343 S KIRKWOOD RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63122-6195
Mailing Address - Country:US
Mailing Address - Phone:314-206-3400
Mailing Address - Fax:314-206-3477
Practice Address - Street 1:1430 OLIVE ST
Practice Address - Street 2:SUITE 500
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63103
Practice Address - Country:US
Practice Address - Phone:314-206-3700
Practice Address - Fax:314-206-3708
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20060236822084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
961501052Medicare UPIN