Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 2016029129 | MO |
NPI | 1033292750 |
---|---|
Provider Name | Dr. Michael W Bebbington |
First Address | Saint Louis, MO 63110-1010 |
Second Address | Saint Louis, MO 63108-1402 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2006 |
Last Update Date | 25/03/2019 |