Individual
DR. TIMOTHY TOBIN BRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10012 KENNERLY RD, STE 101, ST LOUIS, MO 63128
(314) 543-5200
(314) 543-5219
Mailing address
PO BOX 23340, SAINT LOUIS, MO 63156-3340
(314) 543-5200
(314) 543-5219
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
R9C27
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202249520
—
MO
Enumeration date
10/12/2006
Last updated
08/16/2013
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