Provider Demographics
NPI:1144277534
Name:AL-JOUNDI, BASSAM NMI (MD)
Entity type:Individual
Prefix:DR
First Name:BASSAM
Middle Name:NMI
Last Name:AL-JOUNDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10012 KENNERLY ROAD
Mailing Address - Street 2:SUITE #301
Mailing Address - City:ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128
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:2006-05-30
Last Update Date:2016-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR4N86207RC0000X
IL036079696207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2500140OtherUNITED HEALTH CARE
MO45834OtherGROUP HEALTH PLAN
MO21237OtherEXCLUSIVE CHOICE
MO951897OtherAETNA
IL04232002OtherBCBS
MO1017477OtherCARE PARTNERS
MOE64517OtherMERCY HELATH PLAN
MO19559OtherHEALTHCARE USA
MO10954OtherBCBS
MO12557OtherESSENCE HEALTHCARE
MO8860701001OtherCIGNA PAL REFERRAL
MO207774100Medicaid
MO8860701OtherCIGNA HMO PPO OPEN ACCESS
MO917022OtherFIRST HEALTH NETWRORK
MO259827OtherHEALTHLINK
810000169Medicare PIN
MO8860701001OtherCIGNA PAL REFERRAL
E64517Medicare UPIN
MO1017477OtherCARE PARTNERS
MO10954OtherBCBS