Healthcare Provider Details

I. General information

NPI: 1255918298
Provider Name (Legal Business Name): SCOTT ADAM FABRICANT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2021
Last Update Date: 08/11/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BARNES JEWISH HOSPITAL PLZ DIV IM INFECTIOUS DISEASE
SAINT LOUIS MO
63110-1003
US

IV. Provider business mailing address

PO BOX 7412011
CHICAGO IL
60674-2011
US

V. Phone/Fax

Practice location:
  • Phone: 314-747-1206
  • Fax: 314-454-8687
Mailing address:
  • Phone: 314-747-1206
  • Fax: 314-454-8687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number2026033132
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2026033132
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: