Healthcare Provider Details

I. General information

NPI: 1487396537
Provider Name (Legal Business Name): JOANNA CHINEME ABARAOHA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2022
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WUSM PEDS 1 CHILDREN'S PLACE MSC 8116-0043-09
ST LOUIS MO
63110
US

IV. Provider business mailing address

WUSM PEDS 1 CHILDREN'S PLACE MSC 8116-0043-09
ST LOUIS MO
63110
US

V. Phone/Fax

Practice location:
  • Phone: 314-454-6018
  • Fax: 844-621-4392
Mailing address:
  • Phone: 314-454-6018
  • Fax: 844-621-4392

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: