Provider Demographics
NPI:1306166327
Name:MASOOD, MUHAMMAD FARAZ (MD)
Entity type:Individual
Prefix:DR
First Name:MUHAMMAD
Middle Name:FARAZ
Last Name:MASOOD
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 7412011
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-2011
Mailing Address - Country:US
Mailing Address - Phone:314-362-7260
Mailing Address - Fax:866-272-2816
Practice Address - Street 1:11155 DUNN RD
Practice Address - Street 2:DIV SURG CT ADULT CARDIO, STE 209E
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63136-6150
Practice Address - Country:US
Practice Address - Phone:314-362-7260
Practice Address - Fax:866-272-2816
Is Sole Proprietor?:No
Enumeration Date:2010-06-02
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014043719208600000X, 2086S0102X, 208G00000X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200019402Medicaid