HASSAN DAWOUD ELSIDDIG (NPI# 1558563890) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558563890 |
| Entity Type | Individual |
| Full Name | HASSAN DAWOUD ELSIDDIG |
| Credential | M.D. |
| Practice Address |
3660 Vista Ave # 204 Saint Louis MO 63110-2540 |
| Mailing Address |
1083 Rue La Ville Walk Saint Louis MO 63141-6272 |
| Practice Telephone | 3149778462 |
| Practice Fax Number | 3147718575 |
| Mailing Telephone | 3145422501 |
| Mailing Fax Number | 3147718575 |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
2005027548 | PA | Allopathic & Osteopathic Physicians |
| Street Address |
3660 VISTA AVE # 204 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63110-2540 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447453691 | Dulce M. Cruz Oliver | Internal Medicine | 3660 Vista Ave # 204, Saint Louis, MO 63110-2540 | 2007-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659971992 | Carrie Ellen Smith | Nurse Practitioner | Mailstop 90-00-174, One Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-10-27 |
| 1881210466 | Michelle Amanda Freilich | Internal Medicine | Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-06-19 |
| 1245856046 | Jeevin Shahi | Radiology | 3685 Vista Avenue, Center for Radiation Medicine, St. Louis, MO 63110 | 2020-06-18 |
| 1497371314 | Wilson Eduardo Rodriguez | Student in an Organized Health Care Education/Training Program | 1008 S. Spring, St Louis, MO 63110 | 2020-06-17 |
| 1578184065 | Kathryn Kay Lindsay | Registered Nurse | Saint Louis University Dept of Surgery, 3635 Vista Ave 3dt, St Louis, MO 63110 | 2020-05-06 |
| 1881232700 | Ashley Diane Pace | Nurse Practitioner | 1 Parkview Place, Shoenberg 6900, St. Louis, MO 63110 | 2019-12-11 |
| 1619520418 | Krithika Damodar Shenoy | Pathology | 660 Euclid Avenue, One Barnes Jewish Hospital Plaza, St. Louis, MO 63110 | 2019-07-20 |
| 1467912550 | Ian Ferguson | Dermatology | 660 S Euclid Ave., Cb 8123, St. Louis, MO 63110 | 2019-03-23 |
| 1760978688 | Ihab Hassanieh | Student in an Organized Health Care Education/Training Program | 33660 Vista Ave, St. Louis, MO 63110 | 2018-07-03 |
| 1336634500 | Martin K Mwangi | Pediatrics | 1 Childrens Place, 3s34, St. Louis, M, MO 63110 | 2018-06-28 |
| Find all providers in zip 63110 | ||||
| Taxonomy Code | 207RG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. |
| 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 |
|---|---|---|---|---|
| 1023592946 | Institute of Medicine LLC | Internal Medicine | 6824 Balson Ave, Saint Louis, MO 63143-2603 | 2018-09-17 |
| 1104235241 | Generation Clinical Partners LLC | Internal Medicine | 11500 Olive Blvd Ste 235, Saint Louis, MO 63141-7141 | 2014-08-02 |
| 1871795104 | Shehla Sadiq | Internal Medicine | 3660 Vista Ave # 2104, Saint Louis, MO 63110-2540 | 2007-05-31 |
| 1184755118 | Geromed, LLC | Internal Medicine | 4675 S Grand Blvd, Saint Louis, MO 63111-1462 | 2007-03-09 |
| 1851446207 | Poonam M Jain | Internal Medicine | 1 Meadow Acres, Saint Louis, MO 63124-1460 | 2007-01-24 |
| 1154484673 | Miriam B Rodin | Internal Medicine | 1402 S Grand Blvd Rm 238, Division of Geriatric Medicine, Saint Louis, MO 63104-1004 | 2006-12-18 |
| 1992815906 | Susan Robinson Reeds | Internal Medicine | 8 Millstone Campus Dr, Ste 1500, Saint Louis, MO 63146-5766 | 2006-08-30 |
| 1780602417 | Monique Marie Williams | Internal Medicine | 969 N Mason Rd Ste 145, Saint Louis, MO 63141 | 2006-07-18 |
| 1124073630 | Rafi Thomas Kevorkian | Internal Medicine | 522 N New Ballas Rd Ste 317, Saint Louis, MO 63141-6840 | 2006-05-23 |
| 1902881279 | Wit Anthony Jamry | Internal Medicine | 5621 Delmar Blvd, #105, Saint Louis, MO 63112-2656 | 2005-12-09 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63110 |
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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.