Provider Demographics
NPI:1154409399
Name:APPELBAUM, JOHN KENNETH (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:KENNETH
Last Name:APPELBAUM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3023 N BALLAS
Mailing Address - Street 2:STE 120D
Mailing Address - City:ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131
Mailing Address - Country:US
Mailing Address - Phone:314-432-3669
Mailing Address - Fax:314-432-3118
Practice Address - Street 1:3023 N BALLAS
Practice Address - Street 2:STE 120D
Practice Address - City:ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131
Practice Address - Country:US
Practice Address - Phone:314-432-3669
Practice Address - Fax:314-432-3118
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2021-10-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MOR8F50207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
112899OtherBCBS
1259OtherGNP
0700354OtherUNITED
E61667Medicare UPIN