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General NPI Number Information
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NPI Number | 1730528662
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Entity Type | Organization
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Legal Business Name | BARNES JEWISH HOSPITAL
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Dates
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Enumeration Date | 06/25/2013
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Last Update Date | 06/25/2013
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Provider Practice Location Address
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Address Line | 4512 CLEVELAND AVE APT 12
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City | SAINT LOUIS
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State | MO
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Zip | 63110-3318
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Country | US
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Telephone | 716-400-1027
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Fax |
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Provider Business Mailing Address
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Address Line | 4512 CLEVELAND AVE APT 12
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City | SAINT LOUIS
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State | MO
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Zip | 63110-3318
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | RESIDENT PHYSICIAN
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Name | JOSHUA BALDERMAN
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Credential | M.D.
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Telephone | 716-400-1027
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | BALDERMAN JOSHUA VAS
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License Number State | MO
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