Provider Demographics
NPI:1033360839
Name:BRUNWORTH, LOUIS SEITZ (MD)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:SEITZ
Last Name:BRUNWORTH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:701 S NEW BALLAS RD STE 310
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8725
Mailing Address - Country:US
Mailing Address - Phone:314-251-8750
Mailing Address - Fax:314-251-8751
Practice Address - Street 1:701 S NEW BALLAS RD STE 310
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8725
Practice Address - Country:US
Practice Address - Phone:314-251-8750
Practice Address - Fax:314-251-8751
Is Sole Proprietor?:No
Enumeration Date:2008-10-10
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2012020077208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery