NPI 1003260449

Brandon Baumgarten

Practitioner Specialist Hazelwood, MO

Practice location

Address: 7299 Town and Country Pl, Hazelwood, MO 63042-1929
Phone: (219) 629-0982

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence 2013032834 (MO)

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Registry record

NPI: 1003260449
Entity type: Individual
Sex (as registered): Male
NPI issued: 22 Apr 2016
Record last updated: 22 Apr 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.