Healthcare Provider Details

I. General information

NPI: 1972449825
Provider Name (Legal Business Name): MARCUS HOWARD PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2026
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5503 DELMAR BLVD STE B
SAINT LOUIS MO
63112-3122
US

IV. Provider business mailing address

5503 DELMAR BLVD STE B
SAINT LOUIS MO
63112-3122
US

V. Phone/Fax

Practice location:
  • Phone: 314-200-5313
  • Fax: 314-200-0313
Mailing address:
  • Phone: 314-200-5313
  • Fax: 314-200-0313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number2022049277
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: