Provider Demographics
NPI:1255387494
Name:AL-JOUNDI, TAMMAM NMI (MD)
Entity type:Individual
Prefix:DR
First Name:TAMMAM
Middle Name:NMI
Last Name:AL-JOUNDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:10012 KENNERLY RD STE 301
Mailing Address - Street 2:301
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-2197
Mailing Address - Country:US
Mailing Address - Phone:314-729-0088
Mailing Address - Fax:314-729-3963
Practice Address - Street 1:10012 KENNERLY ROAD
Practice Address - Street 2:SUITE 301
Practice Address - City:ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128
Practice Address - Country:US
Practice Address - Phone:314-729-0088
Practice Address - Fax:314-729-3963
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO111666207RC0000X
IL036103650207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO12557OtherESSENCE HEALTHCARE
MO129698OtherBCBS
MO2358779OtherAETNA
IL04232002OtherBCBS
MO1840134OtherFIRST HEALTH NETWORK
MO6325641OtherCIGNA HMO PPO OPEN ACCESS
MO127029OtherCARE PARTNERS
MO208626523Medicaid
MO441679OtherHEALTHLINK
MO21263OtherEXCLUSIVE CHOICE
MO2500250OtherUNITED HEALTH CARE
MO6325641001OtherCIGNA PAL REFERRAL
MOG44678OtherMERCY HEALTH PLAN
MO37625OtherHEALTHCARE USA
MO61903OtherGROUP HEALTH PLAN
IL04232002OtherBCBS
MO6325641001OtherCIGNA PAL REFERRAL
60059782Medicare PIN
MO12557OtherESSENCE HEALTHCARE
MOG44678OtherMERCY HEALTH PLAN