Provider Demographics
NPI:1154396182
Name:ARSHAD, SYED M (MD)
Entity type:Individual
Prefix:
First Name:SYED
Middle Name:M
Last Name:ARSHAD
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:PO BOX 504407
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63150-4407
Mailing Address - Country:US
Mailing Address - Phone:816-502-7000
Mailing Address - Fax:816-932-7957
Practice Address - Street 1:2227 VADALABENE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:MARYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62062-5823
Practice Address - Country:US
Practice Address - Phone:618-288-1140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2016-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015026177207RH0003X
KY40555207RH0003X
IL036140637207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYP00395450OtherRR MEDICARE
MO2015026177OtherLICESNSE
611243OtherHEALTHLINK
KY7100020340Medicaid
611243OtherHEALTHLINK
KYP00395450OtherRR MEDICARE
IN630960WMedicare PIN