Healthcare Provider Details

I. General information

NPI: 1407295512
Provider Name (Legal Business Name): CHELSEA ELIZABETH PEARSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2013
Last Update Date: 04/17/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4921 PARKVIEW PL DIV IM GENERAL MED, STE 12B
SAINT LOUIS MO
63110-1032
US

IV. Provider business mailing address

PO BOX 7412011
CHICAGO IL
60674-2011
US

V. Phone/Fax

Practice location:
  • Phone: 314-747-3969
  • Fax: 877-869-8163
Mailing address:
  • Phone: 314-747-3969
  • Fax: 877-869-8163

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2015007389
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: