Individual
DR. MARK EDWARD HALSTEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
14532 S OUTER 40 RD, DEPT ORTHOPAEDIC SURGERY, STE 200, CHESTERFIELD, MO 63017-5705
(314) 514-3500
(314) 878-7678
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 514-3500
(314) 878-7678
Taxonomy
Speciality
Code
Description
License number
State
2080S0010X
Pediatric Sports Medicine Physician
Primary
2004011774
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209144609
—
MO
Enumeration date
07/18/2006
Last updated
10/09/2025
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