Booth, Candice Beth

Booth, Candice Beth is an individual health care provider with primary practice located at 3015 N Ballas Rd Dept Emergency Med, Saint Louis MO 63131-2329. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / General Practice, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is her primary health care specialty. Booth, Candice Beth can be contacted via phone (314) 966-5000.

Contact Information

Primary practice address
3015 N Ballas Rd Dept Emergency Med Saint Louis MO 63131-2329
Fax: (314) 747-3338
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X 2008006040 Missouri
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 2008006040 Missouri

Profile Details

NPI number 1851418883
LBN Legal business name Booth, Candice Beth
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 23rd, 2007
Last updated Apr 25th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851418883 NPPES
Missouri MEDICAID 200017306

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