Individual
DR. LAWRENCE SIDNEY WALDBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
660 S EUCLID AVE, SAINT LOUIS, MO 63110-1010
(314) 747-3000
Mailing address
660 S EUCLID AVE, C B 8054, SAINT LOUIS, MO 63110-1010
(314) 747-3000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
R6020
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203010174
—
MO
Enumeration date
07/05/2006
Last updated
03/31/2014
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