Healthcare Provider Details
I. General information
NPI: 1861680621
Provider Name (Legal Business Name): MATTHEW A BRINKMEIER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/05/2007
Last Update Date: 04/15/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4901 FOREST PARK AVE DIV IM HOSPITALIST MED, 3RD FL
SAINT LOUIS MO
63108-1495
US
IV. Provider business mailing address
PO BOX 7412011
CHICAGO IL
60674-2011
US
V. Phone/Fax
- Phone: 314-362-1700
- Fax: 314-362-9878
- Phone: 314-362-1700
- Fax: 314-362-9878
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | 2011014999 |
| License Number State | MO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: