Individual
DR. JUSTIN B JOSEPHSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1465 S GRAND BLVD, ST. LOUIS, MO 63104-1003
(314) 577-5663
(314) 268-6410
Mailing address
1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
(314) 577-5642
(314) 268-6410
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
2011010499
MO
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
2011010499
MO
Other
Enumeration date
07/10/2008
Last updated
01/15/2021
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