Individual
DR. ELLIOTT HENRY FARBERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1224 GRAHAM RD, SUITE 3010, FLORISSANT, MO 63031-8028
(314) 921-7509
(314) 921-8205
Mailing address
1224 GRAHAM RD, SUITE 3010, FLORISSANT, MO 63031-8028
(314) 921-7509
(314) 921-8205
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
R5711
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5354
BLUE CROSS BLUE SHIELD ID
MO
Enumeration date
02/15/2007
Last updated
07/08/2007
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