Basic Information
Provider Information
NPI: 1205312972
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ABRO
FirstName: BROOJ
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 660 S EUCLID AVE
Address2:  
City: SAINT LOUIS
State: MO
PostalCode: 631101010
CountryCode: US
TelephoneNumber: 3143625000
FaxNumber:  
Practice Location
Address1: 660 S EUCLID AVE
Address2:  
City: SAINT LOUIS
State: MO
PostalCode: 631101010
CountryCode: US
TelephoneNumber: 3142034144
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/16/2018
LastUpdateDate: 07/15/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/25/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207ZH0000X2020041088MON Allopathic & Osteopathic PhysiciansPathologyHematology
207ZP0102X2017017543MON Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
207ZH0000X91274GAY Allopathic & Osteopathic PhysiciansPathologyHematology

No ID Information.


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