Individual
DR. MICHAEL J BRISCHETTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
621 S NEW BALLAS RD, SUITE 483A, SAINT LOUIS, MO 63141-8232
(314) 251-4966
Mailing address
621 S NEW BALLAS RD, SUITE 228-A, SAINT LOUIS, MO 63141-8232
(314) 251-4966
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
R3C38
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201863800
—
MO
01
—
290014698
RAILROAD MEDICARE
MO
01
—
P00925264
RAILROAD MEDICARE
MO
Enumeration date
02/02/2006
Last updated
07/15/2014
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