Individual
DR. KEITH E ISENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1831 CHESTNUT ST, M/S: MOM904-S350, SAINT LOUIS, MO 63103-2225
(314) 923-8647
(314) 923-4857
Mailing address
1831 CHESTNUT ST, M/S: MOM904-S350, SAINT LOUIS, MO 63103-2225
(314) 923-8647
(314) 923-4857
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
R3C83
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23898
MO-BLUE SHIELD
—
Enumeration date
07/17/2006
Last updated
06/17/2008
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