Provider Demographics
NPI:1104113802
Name:CHIHADE, DEENA BASIMA (MD)
Entity type:Individual
Prefix:DR
First Name:DEENA
Middle Name:BASIMA
Last Name:CHIHADE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:9 N BEMISTON AVE APT 221
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:MO
Mailing Address - Zip Code:63105-3430
Mailing Address - Country:US
Mailing Address - Phone:314-755-1084
Mailing Address - Fax:314-755-1184
Practice Address - Street 1:1300 HRC PLAZA DR
Practice Address - Street 2:
Practice Address - City:LAKE ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63367-1869
Practice Address - Country:US
Practice Address - Phone:314-755-1084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024041400208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery