Provider Demographics
NPI:1538173174
Name:FAQUIR MUHAMMUD, MD, INC
Entity type:Organization
Organization Name:FAQUIR MUHAMMUD, MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FAQUIR
Authorized Official - Middle Name:
Authorized Official - Last Name:MUHAMMUD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-355-6700
Mailing Address - Street 1:11155 DUNN RD
Mailing Address - Street 2:STE 206E
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63136-6150
Mailing Address - Country:US
Mailing Address - Phone:314-355-6700
Mailing Address - Fax:314-355-6820
Practice Address - Street 1:11155 DUNN RD
Practice Address - Street 2:STE 206E
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63136-6150
Practice Address - Country:US
Practice Address - Phone:314-355-6700
Practice Address - Fax:314-355-6820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR8808173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO201362803Medicaid
MO000005387Medicare PIN
MOA11545Medicare UPIN