Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
STEPHEN R BRADDOCK, MD
Active Sole ProprietorSTEPHEN R BRADDOCK, MD is a Geriatric Psychiatry healthcare provider located in ST. LOUIS, Missouri. NPI 1811934490 is currently active in the NPPES registry. Verify at CMS.
Geriatric Psychiatry · ST. LOUIS, MO
Registration Details
- NPI Number
- 1811934490
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 1, 2006 (20.225669484159 yrs)
- Last Updated
- Jan 15, 2021
- Licenses
-
MD106085 (MO)106085 (MO)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1465 S GRAND BLVDST. LOUIS, MO, 631041003Browse MO providers · Browse ZIP 63104
- Phone
- 3145775639
- Fax
- 3142684112
- Primary Specialty
-
Geriatric Psychiatry
207SG0201X
- Additional Specialty
- Geriatric Psychiatry
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.