Provider Demographics
NPI:1093813099
Name:LABONTE, CHRISTOPHER T (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:T
Last Name:LABONTE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1068 S WOODS MILL RD STE 220
Mailing Address - Street 2:
Mailing Address - City:TOWN AND COUNTRY
Mailing Address - State:MO
Mailing Address - Zip Code:63017-8333
Mailing Address - Country:US
Mailing Address - Phone:314-394-1379
Mailing Address - Fax:314-394-1377
Practice Address - Street 1:1068 S WOODS MILL RD STE 220
Practice Address - Street 2:
Practice Address - City:TOWN AND COUNTRY
Practice Address - State:MO
Practice Address - Zip Code:63017-8333
Practice Address - Country:US
Practice Address - Phone:314-394-1379
Practice Address - Fax:314-394-1377
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO110259207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO215425OtherBLUE SHIELD
MO59450OtherHEALTHCARE USA
MOP00355632OtherRR MEDICARE
MO360031OtherHARMONY
MO7052116OtherAETNA
MO111211OtherMERCY MEDICARE
MO8884301OtherMERCY
MO205001316Medicaid
MO937325284Medicare PIN
MO8884301OtherMERCY