Provider Demographics
NPI:1215726484
Name:KHALIFA, SHAIMAA
Entity type:Individual
Prefix:
First Name:SHAIMAA
Middle Name:
Last Name:KHALIFA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5314 JAMIESON AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63109-3348
Mailing Address - Country:US
Mailing Address - Phone:314-371-7274
Mailing Address - Fax:
Practice Address - Street 1:5314 JAMIESON AVE FL 1
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63109-3348
Practice Address - Country:US
Practice Address - Phone:314-371-7274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor