MEDICARE: SHABNAM DARBARI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician	036172282	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225026016
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHABNAM DARBARI MD

Provider Business Mailing Address
First Line	:	PO BOX 959203
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63195-9203
Country	:	US
Telephone Number	:	618-767-3235
Fax Number	:	618-234-6156

Provider Business Practice Location Address
First Line	:	4550 MEMORIAL DR STE 280
Second Line	:
City	:	BELLEVILLE
State	:	IL
Zip	:	62226-5372
Country	:	US
Telephone Number	:	618-767-3235
Fax Number	:	618-234-6156

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2005
Last Update Date	:	01/08/2026

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Directions to “ SHABNAM DARBARI MD” Practice Location

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