Provider Demographics
NPI:1861844383
Name:TOUFAILY, MOHAMAD HASSAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMAD
Middle Name:HASSAN
Last Name:TOUFAILY
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:ONE CHILDREN'S PLACE
Mailing Address - Street 2:3S34
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63112
Mailing Address - Country:US
Mailing Address - Phone:314-454-6006
Mailing Address - Fax:314-454-4102
Practice Address - Street 1:ONE CHILDREN'S PLACE
Practice Address - Street 2:3S34
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63112
Practice Address - Country:US
Practice Address - Phone:314-454-6006
Practice Address - Fax:314-454-4102
Is Sole Proprietor?:No
Enumeration Date:2016-07-08
Last Update Date:2016-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016016395208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics