Provider Demographics
NPI:1124095831
Name:AKHTAR, AAMINA B (MD)
Entity type:Individual
Prefix:
First Name:AAMINA
Middle Name:B
Last Name:AKHTAR
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:10004 KENNERLY ROAD
Mailing Address - Street 2:#171B
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128
Mailing Address - Country:US
Mailing Address - Phone:314-821-0900
Mailing Address - Fax:314-729-1575
Practice Address - Street 1:10004 KENNERLY ROAD
Practice Address - Street 2:#171B
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128
Practice Address - Country:US
Practice Address - Phone:314-821-0900
Practice Address - Fax:314-729-1575
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2017-04-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2000146068207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO205825615Medicaid
MO930763458Medicare ID - Type UnspecifiedMEDICARE
MOH60518Medicare UPIN