MEDICARE: LISA LEE ARMBRUSTER M.D.

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	207Q00000X	Family Medicine Physician	2003007989	MO

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	:	1518930502
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA LEE ARMBRUSTER M.D.

Provider Business Mailing Address
First Line	:	PO BOX 551
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63188-0551
Country	:	US
Telephone Number	:	314-898-1700
Fax Number	:	314-814-8542

Provider Business Practice Location Address
First Line	:	5701 CHIPPEWA ST
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63109-1544
Country	:	US
Telephone Number	:	314-932-5690
Fax Number	:	314-932-5692

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

Provider Enumeration Date	:	02/09/2006
Last Update Date	:	01/12/2022

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