Provider Demographics
NPI:1295140820
Name:JANJUA, MUHAMMAD BURHAN UD DIN (MD)
Entity type:Individual
Prefix:DR
First Name:MUHAMMAD
Middle Name:BURHAN UD DIN
Last Name:JANJUA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:660 S EUCLID AVE
Mailing Address - Street 2:CB 8057
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1010
Mailing Address - Country:US
Mailing Address - Phone:314-362-3577
Mailing Address - Fax:314-367-2017
Practice Address - Street 1:1000 N. LINCOLN BLVD., HHDC 4000
Practice Address - Street 2:SUITE 4103
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104
Practice Address - Country:US
Practice Address - Phone:405-271-8001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-23
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021039566207T00000X, 207T00000X
OK43155207T00000X
TXBP10062767207T00000X
MO2014012729208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1295140820OtherBSBC
MO200103331Medicaid