Provider Demographics
NPI:1396095014
Name:SHAHAB, ASIF SAIYED (MD)
Entity type:Individual
Prefix:
First Name:ASIF
Middle Name:SAIYED
Last Name:SHAHAB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SAIYED
Other - Middle Name:ASIF
Other - Last Name:SHAHAB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:660 S EUCLID AVE
Mailing Address - Street 2:DEPT. OF PATHOLOGY, DIVISION OF ANATOMIC PATHOLOGY
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1010
Mailing Address - Country:US
Mailing Address - Phone:314-362-0101
Mailing Address - Fax:
Practice Address - Street 1:660 S EUCLID AVE
Practice Address - Street 2:DEPT. OF PATHOLOGY, DIVISION OF ANATOMIC PATHOLOGY
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1010
Practice Address - Country:US
Practice Address - Phone:314-362-0101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-11
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012016163207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology