Provider Demographics
NPI:1245365832
Name:M.F. GHANI, M.D., SERVICES, INC.
Entity type:Organization
Organization Name:M.F. GHANI, M.D., SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:F
Authorized Official - Last Name:GHANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-644-5300
Mailing Address - Street 1:PO BOX 240106
Mailing Address - Street 2:
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63024-0106
Mailing Address - Country:US
Mailing Address - Phone:314-644-5300
Mailing Address - Fax:314-644-5308
Practice Address - Street 1:3915 WATSON RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63109-1251
Practice Address - Country:US
Practice Address - Phone:314-644-5300
Practice Address - Fax:314-644-5308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR4716207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200761310Medicaid
A11538Medicare UPIN