Provider Demographics
NPI:1205497070
Name:ALMAJALI, FAWWAZ HUSAM (MD)
Entity type:Individual
Prefix:
First Name:FAWWAZ
Middle Name:HUSAM
Last Name:ALMAJALI
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 1:7342 BALSON AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63130-2901
Mailing Address - Country:US
Mailing Address - Phone:314-662-4221
Mailing Address - Fax:
Practice Address - Street 1:SAINT LOUIS UNIVERSITY,1438 SOUTH GRAND BLVD.ST. LOUIS,
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63104-6313
Practice Address - Country:US
Practice Address - Phone:314-977-4830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-24
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program