Reathaford, Shawn Robert

Reathaford, Shawn Robert is an individual health care provider with primary practice located at 4488 Forest Park Ave Ste 230, Saint Louis MO 63108-2283. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine, Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Reathaford, Shawn Robert can be contacted via phone (314) 535-7855.

Contact Information

Primary practice address
4488 Forest Park Ave Ste 230 Saint Louis MO 63108-2283
Phone: (314) 535-7855
Fax: (314) 534-2803
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine 2080P0204X 2017039852 Missouri
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 2017039852 Missouri
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 2017039852 Missouri

Profile Details

NPI number 1669572343
LBN Legal business name Reathaford, Shawn Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 23rd, 2006
Last updated Apr 25th, 2024 - about 5 months 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669572343 NPPES
Missouri MEDICAID 200049825

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