Individual provider · NPI-1

Bradley A Becker, MD

Pediatrics, Pediatric Allergy/Immunology · Saint Louis, MO

NPI number1609887983
StatusActive
Last updated in NPPESJan 15, 2021

Details

NPI
1609887983
Entity type
Individual (NPI-1)
Name
Bradley A Becker
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Aug 11, 2006
Certification date
Jan 15, 2021
Last updated
Jan 15, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2080P0201X Pediatrics, Pediatric Allergy/Immunology106905MOYes
207K00000X Allergy & Immunology106905MO
208000000X Pediatrics106905MO
2080I0007X Pediatrics, Clinical & Laboratory Immunology106905MO

Practice location

1465 S Grand Blvd
Saint Louis, MO 63104-1003

Phone 314-268-4014 · Fax 314-268-2712

Mailing address

1465 S Grand Blvd
Saint Louis, MO 63104-1003

Phone 314-268-4104 · Fax 314-268-2712

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