Elfenbein, Dianne S

Elfenbein, Dianne S is an individual health care provider with primary practice located at 1465 S Grand Blvd Division Of Adolescent Medicine, Saint Louis MO 63104-1003. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Adolescent Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Adolescent Medicine is her primary health care specialty. Elfenbein, Dianne S can be contacted via phone (314) 268-6406.

Contact Information

Primary practice address
1465 S Grand Blvd Division Of Adolescent Medicine Saint Louis MO 63104-1003
Phone: (314) 268-6406
Fax: (314) 268-2712
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X 2009036450 Missouri
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 2009036450 Missouri

Profile Details

NPI number 1316937626
LBN Legal business name Elfenbein, Dianne S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 27th, 2005
Last updated Jun 17th, 2013 - about 13 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 1316937626 NPPES
Missouri MEDICAID 3206866

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