Azrak, Elie C
Azrak, Elie C is an individual health care provider with primary practice located at 12266 De Paul Dr Ste 205 , Bridgeton MO 63044-2514. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Azrak, Elie C can be contacted via phone (314) 218-2300.Contact Information
Primary practice address
12266 De Paul Dr Ste 205
Bridgeton MO 63044-2514
Phone: (314) 218-2300
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 036110194 | Illinois |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 106181 | Missouri |
Profile Details
| NPI number | 1962495952 |
|---|---|
| LBN Legal business name | Azrak, Elie C |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 25th, 2005 |
| Last updated | Oct 19th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1962495952 | NPPES |
| Missouri | Other | 183083 | MOBC/BS, BLUE CHOICE |
| Missouri | Other | 431098908 | MOBC/BS, BLUE CHOICE |
| Missouri | Other | 072208 | MOBC/BS, BLUE CHOICE |
| Missouri | Other | 435756 | MOBC/BS, BLUE CHOICE |
| Missouri | Other | 9779268001 | MOBC/BS, BLUE CHOICE |
| Missouri | Other | P00289356 | MOBC/BS, BLUE CHOICE |
| Missouri | Other | P00279137 | MOBC/BS, BLUE CHOICE |
| Missouri | Other | 185761V3831 | MOBC/BS, BLUE CHOICE |
| Missouri | Other | 000000013096 | MOBC/BS, BLUE CHOICE |
| Missouri | MEDICAID | 204870026 | MOBC/BS, BLUE CHOICE |
| Missouri | Other | 22724 | MOBC/BS, BLUE CHOICE |
| Missouri | Other | G57442 | MOBC/BS, BLUE CHOICE |
| Missouri | Other | P00149798 | MOBC/BS, BLUE CHOICE |
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