Elias Ghossoub, MD

Primary specialty

Forensic Psychiatry PhysicianTaxonomy code 2084F0202X

License

2017018863 Issued in MO

Practice address

1438 S Grand Blvd RM 7
Saint Louis, MO 63104-1027

Phone

(314) 977-4826

Fax

(314) 977-1099

NPI assigned

Jul 20, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1500508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1528581683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1438 S GRAND BLVD RM 7",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041027",
            "telephone_number": "314-977-4826",
            "fax_number": "314-977-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1438 S GRAND BLVD RM 7",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041027",
            "telephone_number": "314-977-4826",
            "fax_number": "314-977-1099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHOSSOUB",
        "first_name": "ELIAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-20",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "MO",
            "license": "2017018863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ebony Gholston
• Sharon Ghormley
• Nillima Nellie Ghosh, DO
• Sean Jon Ghosh, M.D.
• Nupur Ghoshal, MD
• Shakira Ghulam Mohammad
• Madeline Kay Giacalone, D.O.
• Mike H. Giacaman, M.D.
• Bria Dugolenski Giacomino, DO
• Laurel Giacone, RBT

• Forensic Psychiatry Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Forensic Psychiatry Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.