Metro Medical Clinic South LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

METRO MEDICAL CLINIC SOUTH LLC

Practice address

3535 S Jefferson Ave
Saint Louis, MO 63118-3930

Phone

(314) 260-9560

NPI assigned

Mar 6, 2013

Last updated

May 16, 2013By 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

Jawed Siddiqui, MD

Title

Owner

Phone

(314) 260-9560

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1362528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368662400000",
    "number": "1871834408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 S JEFFERSON AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631183930",
            "telephone_number": "314-260-9560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 S JEFFERSON AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631183930",
            "telephone_number": "314-260-9560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METRO MEDICAL CLINIC SOUTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-06",
        "last_updated": "2013-05-16",
        "status": "A",
        "authorized_official_last_name": "SIDDIQUI",
        "authorized_official_first_name": "JAWED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-260-9560",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Internal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2013; 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.