Provider Demographics
NPI:1447446489
Name:SAFI, MALAZ (MD)
Entity type:Individual
Prefix:DR
First Name:MALAZ
Middle Name:
Last Name:SAFI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 31817
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-0817
Mailing Address - Country:US
Mailing Address - Phone:314-543-2850
Mailing Address - Fax:314-543-2851
Practice Address - Street 1:8790 WATSON RD
Practice Address - Street 2:SUITE. 203
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63119-5140
Practice Address - Country:US
Practice Address - Phone:314-543-2850
Practice Address - Fax:314-543-2851
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-24
Last Update Date:2014-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR9B71207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL180007127OtherRAIL ROAD MEDICARE
MO180007127OtherRAILROAD MEDICARE
MO201857232Medicaid
MO321857203OtherMEDICAID OPTICAL
MO180007127OtherRAILROAD MEDICARE
A10241Medicare UPIN
MO201857232Medicaid