Provider Demographics
NPI:1952494932
Name:NYAZEE, MUHAMMAD A (MD)
Entity Type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:A
Last Name:NYAZEE
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 1:6 JUNGERMANN CIR STE 215
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-1626
Mailing Address - Country:US
Mailing Address - Phone:636-928-1231
Mailing Address - Fax:636-922-2332
Practice Address - Street 1:11155 DUNN RD STE 212E
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63136-6166
Practice Address - Country:US
Practice Address - Phone:314-837-4200
Practice Address - Fax:314-972-0402
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR3C90207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO201736105Medicaid
MO201736105Medicaid
MOA11120Medicare UPIN
MO002012709Medicare PIN