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Search › Missouri › 2080S0012X

Brent Haberman, MD

NPI 1699977686 · on the registry since 2007 · sole proprietor

Practice

Address
1465 S Grand Blvd
Saint Louis, MO 63104
Phone
(314) 268-6413
Fax
(314) 268-6412
Organisation at this address
Lifenet, Inc.
St Louis University
St Louis University
St Louis University
St Louis University
Inferred from a shared address, not stated in the registry.
Clinicians at this address
531

Registry record

Primary taxonomy
2080S0012X
2080S0012X
Also registered as
208000000X
2080P0214X
2080P0214X
Licence states on file
MO, TN
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2021-03-11

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Missouri