Provider Demographics
NPI:1154852598
Name:NOONAN, ELIZABETH MCCARTER (MD)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:MCCARTER
Last Name:NOONAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:JOAN
Other - Last Name:MCCARTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1465 S GRAND BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63104-1003
Mailing Address - Country:US
Mailing Address - Phone:314-577-5680
Mailing Address - Fax:314-268-4021
Practice Address - Street 1:1465 S GRAND BLVD RM 2717
Practice Address - Street 2:1465 SOUTH GRAND BLVD, RM 2717
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63104-1003
Practice Address - Country:US
Practice Address - Phone:314-577-5634
Practice Address - Fax:314-577-5616
Is Sole Proprietor?:No
Enumeration Date:2017-03-27
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020015474208000000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics