| Doctor Name: | MR. JOHN DAVID BOUHASIN |
| NPI Number: | 1083858336 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 26684 |
| Business Practice Address: | 7629 Bracken Circle St. Louis, MO - 63123 |
| Business Phone Number: | 3148427629 |
| Business Fax Number: | 3148427529 |
| Mailing Address: | 7629 Bracken Circle, ST. LOUIS |
| State: | MO |
| Postal Code: | 63123 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 04/29/2009 |
| NPI Last Update Date: | 04/29/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2080P0207X |
| License Number: | 26684 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Pediatrics |
| Taxonomy Specialization: | Pediatric Hematology-Oncology |
| Taxonomy Definition: | A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases. |