Individual
MR. RAAD R ROUBEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12255 DE PAUL DR STE 600, BRIDGETON, MO 63044-2515
(314) 209-5120
Mailing address
PO BOX 955534, SAINT LOUIS, MO 63195-5534
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
108153
MO
208M00000X
Hospitalist Physician
108153
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0403350
UNITED HEALTH CARE
MO
01
—
101187
GROUP HEALTH PLAN
MO
01
—
109111
GHP/PARTNERS
MO
01
—
122719
BLUE CROSS BLUE SHIELD
MO
01
—
152508
ANTHEM BLUE CROSS BLUE SH
MO
05
—
204012918
—
MO
01
—
413539
HEALTHLINK
MO
01
—
5274793
AETNA
MO
Enumeration date
02/01/2007
Last updated
03/17/2021
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