Individual
MATTHEW A BROOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1465 S GRAND BLVD, ST. LOUIS, MO 63104-1003
(314) 268-4070
(314) 268-4021
Mailing address
1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
(314) 268-4070
(314) 268-4021
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2006004155
MO
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
2006004155
MO
Other
Enumeration date
06/08/2006
Last updated
07/28/2023
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