Broyles, Damon R.
Broyles, Damon R. is an individual health care provider with primary practice located at 714 Gravois Rd Suite 210, Fenton MO 63026-7727. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Broyles, Damon R. can be contacted via phone (314) 543-5230.Contact Information
Primary practice address
714 Gravois Rd Suite 210
Fenton MO 63026-7727
Phone: (314) 543-5230
Fax: (314) 543-5280
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 2004002145 | Missouri |
Profile Details
| NPI number | 1407856396 |
|---|---|
| LBN Legal business name | Broyles, Damon R. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 21st, 2005 |
| Last updated | Apr 7th, 2010 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407856396 | NPPES |
| Missouri | MEDICAID | 208987800 |
Popular Providers
-
Covert, Laura Michelle
1203 Smizer Mill Rd Ste 105, Fenton MO 63026-3483 -
Auld, Jessica Therese
1203 Smizer Mill Rd Ste 105 , Fenton MO 63026-3483 -
Crowe, John Martin
1670 Fenpark Dr , Fenton MO 63026-2918 -
Stein, Melissa K
714 Gravois Rd Ste 100, Fenton MO 63026-7727 -
Ludlow, Sarah
1345 Smizer Mill Rd Ste 1100 , Fenton MO 63026-7305 -
Pullam, Kristopher Vaughn
1203 Smizer Mill Rd Ste 105 , Fenton MO 63026-3483 -
Buckley, Brenda Lynn
1747 Smizer Station Rd Suite 5, Fenton MO 63026-2784 -
Zimmerman, Matthew Thomas
714 Gravois Rd Ste 210 , Fenton MO 63026-7723