Basic Information
Provider Information
NPI: 1740702539
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SYED
FirstName: SALMAN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: GIM, 2ND FLOOR
Address2: 1008 SOUTH SPRING
City: ST. LOUIS
State: MO
PostalCode: 631102520
CountryCode: US
TelephoneNumber: 3142578222
FaxNumber: 3145778019
Practice Location
Address1: 1201 S GRAND BLVD
Address2:  
City: SAINT LOUIS
State: MO
PostalCode: 631041016
CountryCode: US
TelephoneNumber: 3142578000
FaxNumber: 7736653411
Other Information
ProviderEnumerationDate: 07/12/2017
LastUpdateDate: 04/01/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/09/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
208M00000X2020017474MOY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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