Nouri-Moghaddam, Soraya

Nouri-Moghaddam, Soraya is an individual health care provider with primary practice located at 1 Childrens Pl Suite 5S30, Saint Louis MO 63110-1002. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Cardiology, which is considered as her primary health care specialty. Nouri-Moghaddam, Soraya can be contacted via phone (314) 454-6095.

Contact Information

Primary practice address
1 Childrens Pl Suite 5S30 Saint Louis MO 63110-1002
Phone: (314) 454-6095
Fax: (314) 454-4801
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Cardiology 2080P0202X R8238 Missouri

Profile Details

NPI number 1104842327
LBN Legal business name Nouri-Moghaddam, Soraya
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2006
Last updated Jul 16th, 2009 - about 15 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104842327 NPPES
Illinois MEDICAID 9170765004
Illinois MEDICAID 200889129

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