| Doctor Name: | MR. TAHIR QAYUM |
| NPI Number: | 1306907738 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 106241 |
| Business Practice Address: | 12700 Southfork Road Suite 220 Saint Louis, MO - 631282106 |
| Business Phone Number: | 3145435942 |
| Business Fax Number: | 3145435947 |
| Mailing Address: | 12700 Southfork Road, Suite 220 SAINT LOUIS |
| State: | MO |
| Postal Code: | 631282106 |
| Phone Number: | 3145435942 |
| Fax Number: | 3145435947 |
| NPI Enumeration Date: | 12/12/2006 |
| NPI Last Update Date: | 06/14/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 106241 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MO |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |