Healthcare Provider Details

I. General information

NPI: 1952396251
Provider Name (Legal Business Name): ERAN MARION HAHN II MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2005
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3466 MCKELVEY RD
BRIDGETON MO
63044-2533
US

IV. Provider business mailing address

PO BOX 959318
SAINT LOUIS MO
63195-8512
US

V. Phone/Fax

Practice location:
  • Phone: 314-344-8100
  • Fax: 314-344-8102
Mailing address:
  • Phone: 573-885-6600
  • Fax: 573-885-6610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number2003023593
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: