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General NPI Number Information
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NPI Number | 1427626431
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Entity Type | Individual
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Provider Name | CHRISTINA MARIE HERBOSA MD
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Gender | Female
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Dates
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Enumeration Date | 06/15/2021
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Last Update Date | 08/06/2025
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Provider Practice Location Address
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Address Line | 4901 FOREST PARK AVE DIV OBGYN PELVIC MED/RECONSTRUCT SURG, STE 710
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City | SAINT LOUIS
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State | MO
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Zip | 63108-1495
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Country | US
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Telephone | 314-747-1402
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Fax | 844-661-9887
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Provider Business Mailing Address
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Address Line | PO BOX 7412011
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City | CHICAGO
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State | IL
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Zip | 60674-2011
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Country | US
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Telephone | 314-747-1402
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Fax | 844-661-9887
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 2025030748
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License Number State | MO
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