Provider Demographics
NPI:1316938863
Name:BROOK, ALAN D (MD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:D
Last Name:BROOK
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Gender:M
Credentials:MD
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Mailing Address - Street 1:11133 DUNN RD
Mailing Address - Street 2:SUITE 2335
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63136-6119
Mailing Address - Country:US
Mailing Address - Phone:314-653-5007
Mailing Address - Fax:314-653-4149
Practice Address - Street 1:6 JUNGERMANN CIR
Practice Address - Street 2:SUITE 210
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-1621
Practice Address - Country:US
Practice Address - Phone:636-441-6056
Practice Address - Fax:636-441-0620
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2010-01-04
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Provider Licenses
StateLicense IDTaxonomies
MO103141207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO204014518Medicaid
MO000010417Medicare PIN
MO000012234Medicare PIN
MO008010417Medicare ID - Type UnspecifiedCPIN
MO000010902Medicare PIN
MOG90092Medicare UPIN