Provider Demographics
NPI:1962550319
Name:BROWNRIDGE, SETH JONATHAN (MD)
Entity type:Individual
Prefix:DR
First Name:SETH
Middle Name:JONATHAN
Last Name:BROWNRIDGE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5992 HOWDERSHELL RD STE 106
Mailing Address - Street 2:
Mailing Address - City:HAZELWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63042-4109
Mailing Address - Country:US
Mailing Address - Phone:314-731-1299
Mailing Address - Fax:314-731-2145
Practice Address - Street 1:5992 HOWDERSHELL RD STE 106
Practice Address - Street 2:
Practice Address - City:HAZELWOOD
Practice Address - State:MO
Practice Address - Zip Code:63042-4109
Practice Address - Country:US
Practice Address - Phone:314-731-1299
Practice Address - Fax:314-731-2145
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2021-03-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO36583208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO202258414Medicaid