Provider Demographics
NPI:1851341366
Name:NASEER, KHALID (MD)
Entity Type:Individual
Prefix:
First Name:KHALID
Middle Name:
Last Name:NASEER
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 1:3009 N BALLAS RD STE 359C
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-2324
Mailing Address - Country:US
Mailing Address - Phone:314-996-3520
Mailing Address - Fax:
Practice Address - Street 1:3009 N BALLAS RD STE 359C
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-2324
Practice Address - Country:US
Practice Address - Phone:314-996-3520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007001669207RG0100X
IL036121860207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO207173600Medicaid
MO1851341366Medicaid
MOP01135243OtherRAILROAD MEDICARE
MO207173600Medicaid
MOMA4280004Medicare PIN
ILF400223462Medicare PIN
129430017Medicare PIN
MO126990001Medicare UPIN
MO969755654Medicare PIN