Provider Demographics
NPI:1104003771
Name:COLLIER, LORA PEARLMAN (MD)
Entity Type:Individual
Prefix:
First Name:LORA
Middle Name:PEARLMAN
Last Name:COLLIER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LORA
Other - Middle Name:REBECCA
Other - Last Name:PEARLMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 23340
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63156-3340
Mailing Address - Country:US
Mailing Address - Phone:314-567-7337
Mailing Address - Fax:314-851-4476
Practice Address - Street 1:13001 N OUTER 40 RD STE 320
Practice Address - Street 2:
Practice Address - City:TOWN AND COUNTRY
Practice Address - State:MO
Practice Address - Zip Code:63017
Practice Address - Country:US
Practice Address - Phone:314-567-7337
Practice Address - Fax:314-851-4476
Is Sole Proprietor?:No
Enumeration Date:2008-01-26
Last Update Date:2018-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006016374208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2184242OtherCIGNA
MO95462OtherHCUSA
MO9163352OtherAETNA
MO495032OtherCOVENTRY
MO000000626941OtherBCBS
MO976876OtherHEALTHLINK
MO3041736OtherUHC