Individual
ANGELA M HOLBROOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
605 E BOONESLICK RD, WARRENTON, MO 63383-2127
(636) 456-0188
Mailing address
1836 LACKLAND HILL PKWY, ATTN: CREDENTIALING, SAINT LOUIS, MO 63146-3572
(314) 989-0300
(314) 810-1399
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
103133
MO
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
103133
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790731545
—
MO
Enumeration date
05/25/2006
Last updated
01/15/2009
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