SOOPHIA KHAN NAYDENOV (NPI# 1558562900) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1558562900 |
Entity Type | Individual |
Full Name | SOOPHIA KHAN NAYDENOV |
Credential | M.D. |
Practice Address |
1402 S Grand Blvd Saint Louis MO 63104-1004 |
Mailing Address |
845 Coulange Ct Creve Coeur MO 63141-7340 |
Practice Telephone | 3145778856 |
Mailing Telephone | 3146296481 |
Enumeration Date | 2007-05-31 |
Last Update Date | 2012-07-05 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207R00000X | Internal Medicine | 2009018161 | MO | Allopathic & Osteopathic Physicians |
Y | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
2009018161 | MO | Allopathic & Osteopathic Physicians |
N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
2009018161 | MO | Allopathic & Osteopathic Physicians |
N | 390200000X | Student in an Organized Health Care Education/Training Program | 2009018161 | MO | Student, Health Care |
Street Address |
1402 S GRAND BLVD |
City | SAINT LOUIS |
State | MO |
Zip Code | 63104-1004 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588649271 | Fred W Rottnek | Family Medicine | 1402 S Grand Blvd, Family and Community Medicine, Saint Louis, MO 63104-1004 | 2005-12-14 |
1891305819 | Ahmed Eltarras | Internal Medicine | 1402 S Grand Blvd, Saint Louis, MO 63104-1004 | 2020-08-04 |
1265058309 | Anu Rijal | Pathology | 1402 S Grand Blvd, Saint Louis, MO 63104-1004 | 2020-06-24 |
1760005706 | Mehmet Tamer | Internal Medicine | 1402 S Grand Blvd, Saint Louis, MO 63104-1004 | 2020-05-26 |
1275156523 | Muhammad Murtaza Alam | Student in an Organized Health Care Education/Training Program | 1402 S Grand Blvd, Saint Louis, MO 63104-1004 | 2020-05-21 |
1235758442 | Ryan Walde | Student in an Organized Health Care Education/Training Program | 1402 S Grand Blvd, Saint Louis, MO 63104-1004 | 2020-04-09 |
1770148876 | David Starr | Student in an Organized Health Care Education/Training Program | 1402 S Grand Blvd, Saint Louis, MO 63104-1004 | 2019-05-03 |
1932763703 | Kate Beatriz Alemann | Student in an Organized Health Care Education/Training Program | 1402 S Grand Blvd, Saint Louis, MO 63104-1004 | 2019-04-27 |
1144783648 | Jakob Hockman | Student in an Organized Health Care Education/Training Program | 1402 S Grand Blvd, Saint Louis, MO 63104-1004 | 2019-04-11 |
1518426485 | Matthew K Kaili | Student in an Organized Health Care Education/Training Program | 1402 S Grand Blvd, Saint Louis, MO 63104-1004 | 2019-03-19 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407469570 | Family Care Health Centers | Clinic/Center | 2717 Sidney Street, St. Louis, MO 63104 | 2020-08-28 |
1023638038 | Laura Ann Humphrey | Physician Assistant | Allied Health Building 3437 Caroline Street, Room 3015, Saint Louis, MO 63104 | 2020-04-20 |
1174187264 | Ahsan Ali | Student in an Organized Health Care Education/Training Program | 1438 South Grand Blvd, Monteleone Hall, St. Louis, MO 63104 | 2019-04-24 |
1205359916 | Brenda Eve Ladin | Behavior Technician | 1221 Allen Market Lane Rear, St. Louis, MO 63104 | 2017-07-25 |
1841722063 | Gustavo G Mendez | Student in an Organized Health Care Education/Training Program | 1465 South Grand Bulevard Rm 2717, Ssm Health Cardinal Glennon Children's Hospital, Saint Louis, MO 63104 | 2017-03-28 |
1053776716 | Carmella Harper | Respiratory Therapist, Certified | 2678 Park Ave, St Louis, MO 63104 | 2015-12-23 |
1922485986 | Alexander Tremont | Internal Medicine | 1402 S Grand Blvd Rm M260, Saint Louis, MO 63104 | 2015-04-29 |
1306233341 | Healthcare R Us | Home Health | 2859 Sidney St, St Louis, MO 63104 | 2015-04-16 |
1396159091 | Daniela Hermelin | Pathology | 1402 South Grane, St. Louis, MO 63104 | 2014-06-20 |
1992117881 | Kelly Denise Durbin | Social Worker | 1920 S 7th St, Saint Louis, MO 63104 | 2014-05-27 |
Find all providers in zip 63104 |
Taxonomy Code | 207RC0200X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Critical Care Medicine |
An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275845208 | Jimmy L Moss | Internal Medicine | 12634 Olive Blvd Dept Of, Saint Louis, MO 63141-6337 | 2010-07-07 |
1871585356 | Salvador Lobianco | Internal Medicine | 11155 Dunn Rd, Ste: 315e, Saint Louis, MO 63136-6150 | 2005-08-19 |
1235121013 | Nadeem D Parkar | Internal Medicine | 3635 Vista At Grand, Radiology Dept - Sluh, Saint Louis, MO 63110-0250 | 2005-08-18 |
1376546804 | Nadeem Ahmed | Internal Medicine | 777 Craig Rd Ste 130, Saint Louis, MO 63141-7133 | 2005-05-30 |
1194255455 | Christopher David Coriasso | Internal Medicine | 625 S New Ballas Rd Ste 7020, Saint Louis, MO 63141-8218 | 2017-06-19 |
1669882205 | Justin Grady | Internal Medicine | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2014-05-05 |
1760815740 | Inpatient Consultants of Missouri Inc | Internal Medicine | 12125 Woodcrest Executive Dr Ste 220, Saint Louis, MO 63141-5010 | 2013-08-14 |
1083977367 | Peter Kang | Internal Medicine | 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110-1003 | 2012-06-21 |
1861758526 | Keith Timothy Ferguson | Internal Medicine | 3660 Vista Ave, Saint Louis, MO 63110-2540 | 2012-04-06 |
1013203454 | Karthik Iyer | Internal Medicine | 1100 S Grand Blvd, Drc 831, Saint Louis, MO 63104-1015 | 2011-06-23 |
Find all providers in SAINT LOUIS |
City | SAINT LOUIS |
Zip Code | 63104 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.