Individual
DR. EDMOND S WEISBART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4901 FOREST PARK AVE, WOHL CLINIC STE 241, SAINT LOUIS, MO 63108-1402
(314) 362-5060
(314) 362-6959
Mailing address
660 S EUCLID AVE, C B 8121, SAINT LOUIS, MO 63110-1010
(314) 362-5060
(314) 362-6959
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2003028097
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036064108
—
IL
05
—
208314708
—
MO
Enumeration date
05/27/2005
Last updated
01/29/2018
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