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Individual

DR. BRAXTON HENRY DEGARMO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
433 CARSON RD, SAINT LOUIS, MO 63135-2317
(314) 522-3957
(314) 522-3957
Mailing address
433 CARSON RD, FERGUSON, MO 63135-2317
(314) 229-2939

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
R7F46
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
202273629
MO
05
202273637
MO
Enumeration date
06/22/2006
Last updated
02/06/2016
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