MEDICARE: DR. LAURIE A KLABI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	101718	MO
2	207VG0400X	Gynecology Physician	101718	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	110174	OTHER	MO	BLUE CROSS BLUE SHIELD
2	5585016	OTHER	MO	AETNA

General Provider Information

NPI Number	:	1326074907
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAURIE A KLABI M.D.

Provider Business Mailing Address
First Line	:	3023 N BALLAS RD STE 600D
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63131-2332
Country	:	US
Telephone Number	:	314-996-4880
Fax Number	:

Provider Business Practice Location Address
First Line	:	3023 N BALLAS RD STE 600D
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63131-2332
Country	:	US
Telephone Number	:	314-996-4880
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2006
Last Update Date	:	06/20/2023

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