Individual
DR. VADIM YURI BARAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10420 OLD OLIVE STREET RD, STE 205, SAINT LOUIS, MO 63141-5914
(314) 504-4698
(314) 692-9978
Mailing address
10420 OLD OLIVE STREET RD, STE 205, SAINT LOUIS, MO 63141-5914
(314) 504-4698
(314) 692-9978
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
2004022302
MO
2084P0805X
Geriatric Psychiatry Physician
2004022302
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0-549-411-7
ECFMG CERTIFICATE
MO
01
—
041854
CONNECTICUT LICENSE
CT
01
—
11541376
CAQH
MO
01
—
2004022302
MISSOURI LICENSE
MO
05
—
209106814
—
MO
05
—
209106822
—
MO
01
—
230500
LICENSE
NY
01
—
353493570
BNDD
MO
Enumeration date
01/15/2006
Last updated
03/07/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us