Individual
BRENT K. HABERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
(314) 268-6413
(314) 268-6412
Mailing address
1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
(314) 268-6439
(314) 268-6412
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
2016042899
MO
2080P0214X
Pediatric Pulmonology Physician
2016042899
MO
2080P0214X
Pediatric Pulmonology Physician
47526
TN
2080S0012X
Pediatric Sleep Medicine Physician
Primary
2016042899
MO
Other
Enumeration date
06/03/2007
Last updated
03/11/2021
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