Provider Demographics
NPI:1184980716
Name:JAMAL, ALI AYMAN (MD)
Entity type:Individual
Prefix:
First Name:ALI
Middle Name:AYMAN
Last Name:JAMAL
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1465 S GRAND BLVD
Mailing Address - Street 2:ROOM 1204
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63104-1003
Mailing Address - Country:US
Mailing Address - Phone:314-577-5600
Mailing Address - Fax:314-577-5616
Practice Address - Street 1:1465 S GRAND BLVD
Practice Address - Street 2:ROOM 1204
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63104
Practice Address - Country:US
Practice Address - Phone:314-577-5600
Practice Address - Fax:314-577-5616
Is Sole Proprietor?:No
Enumeration Date:2012-04-09
Last Update Date:2018-07-12
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Provider Licenses
StateLicense IDTaxonomies
MO20180142082084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology