Most Relevant Information
Provider Data
| NPI Number: | 1003260787 |
| Provider Name: | GHULAM GHOUS M.D |
| Entity Type: | Individual |
| Taxonomy Code: | 207RH0003X |
| Specialty: | Internal Medicine |
| License Number: | 2019024548 |
Most Important Dates
| Enumeration Date: | 04/19/2016 |
| Last Updated: | 04/29/2024 |
Provider Practice Location
1125 MADISON ST
JEFFERSON CITY
MO
651015227
Practice Location Phone/Fax
| Phone: | 5736325000 |
| Fax: | 5736342033 |
Provider Mailing Location
PO BOX 843966
KANSAS CITY
MO
641843966
Provider Mailing Phone/Fax
| Phone: | 5738843300 |
| Fax: | 5738840943 |