Waqar Ulislam Mirza MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

R4N72 Issued in MO

Legal business name

WAQAR ULISLAM MIRZA MD

Practice address

12277 De Paul Dr
Suite 401
Bridgeton, MO 63044-2516

Phone

(314) 628-1408

NPI assigned

Dec 17, 2015

Last updated

Dec 17, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Christina Fleming

Title

Billing Office

Phone

(314) 628-1408

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1450310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450310400000",
    "number": "1639534654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844010",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641844010",
            "telephone_number": "314-628-1408",
            "fax_number": "314-336-0562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12277 DE PAUL DR",
            "address_2": "SUITE 401",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442516",
            "telephone_number": "314-628-1408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAQAR ULISLAM MIRZA MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-17",
        "last_updated": "2015-12-17",
        "status": "A",
        "authorized_official_last_name": "FLEMING",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_title_or_position": "BILLING OFFICE",
        "authorized_official_telephone_number": "314-628-1408"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MO",
            "license": "R4N72",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Waller
• Alyssa Walters, MOT, OTR/L
• Kongkeo Thiky Walther, ANP
• William Wang, M.D.
• Victoria Wannemuehler, MS, RDN, LD
• Jeniffer Ane Washington
• Keisha L Waters
• Alecia Watts, MSW, LMSW
• L Marilyn Weaks, DMD
• Robin Anne Weaver, M.P.T.

• Neurology Physician in Bridgeton, MO
• Providers in Bridgeton, MO by specialty
• Neurology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2015; 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.