Basic Information
| Provider Information | |||||||||
| NPI: | 1619968336 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FOROUGHI | ||||||||
| FirstName: | VAFA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14825 NORTH OUTER FORTY RD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | CHESTERFIELD | ||||||||
| State: | MO | ||||||||
| PostalCode: | 63017 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6368984707 | ||||||||
| FaxNumber: | 6368984709 | ||||||||
| Practice Location | |||||||||
| Address1: | 14825 NORTH OUTER FORTY RD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | CHESTERFIELD | ||||||||
| State: | MO | ||||||||
| PostalCode: | 63017 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6368984707 | ||||||||
| FaxNumber: | 6368984709 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/02/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 100645 | MO | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.