MEDICARE: DR. MERAV BEN DAVID MD

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	2084N0008X	Neuromuscular Medicine (Psychiatry & Neurology) Physician	2017014265	MO

General Provider Information

NPI Number	:	1992227045
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MERAV BEN DAVID MD

Provider Business Mailing Address
First Line	:	660 S EUCLID AVE
Second Line	:	DEPARTMENT OF NEUROLOGY , CAMPUS BOX 8111
City	:	SAINT LOUIS
State	:	MO
Zip	:	63110-1010
Country	:	US
Telephone Number	:	314-362-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	BARNES- JEWISH HOSPITAL PLAZA
Second Line	:
City	:	ST LOUIS
State	:	MO
Zip	:	63110-6311
Country	:	US
Telephone Number	:	314-362-5000
Fax Number	:

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

Provider Enumeration Date	:	07/11/2017
Last Update Date	:	07/11/2017

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