Individual
DR. BRIAN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12277 DE PAUL DR STE 100, BRIDGETON, MO 63044-2577
(314) 209-5142
Mailing address
PO BOX 955534, SAINT LOUIS, MO 63195-5534
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35.134016
OH
207RH0000X
Hematology (Internal Medicine) Physician
Primary
2021011406
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/19/2015
Last updated
07/26/2021
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