Healthcare Provider Details

I. General information

NPI: 1013581776
Provider Name (Legal Business Name): LIBBY WEI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2021
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 S BRENTWOOD BLVD STE 700
BRENTWOOD MO
63144-1304
US

IV. Provider business mailing address

8820 LADUE RD STE 203
SAINT LOUIS MO
63124-2080
US

V. Phone/Fax

Practice location:
  • Phone: 314-367-1181
  • Fax:
Mailing address:
  • Phone: 314-367-1181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number036.173914
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number2025016978
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: