Provider Demographics
NPI:1346285913
Name:PERSCHBACHER, PATRICIA PLADSON (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:PLADSON
Last Name:PERSCHBACHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2821 N BALLAS RD STE C-61
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-2321
Mailing Address - Country:US
Mailing Address - Phone:314-918-5508
Mailing Address - Fax:314-918-5052
Practice Address - Street 1:2821 N BALLAS RD STE C-61
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-2321
Practice Address - Country:US
Practice Address - Phone:314-918-5508
Practice Address - Fax:314-918-5052
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005009931207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOH65395Medicare UPIN
MO932501322Medicare ID - Type Unspecified