Provider Demographics
NPI:1255319323
Name:BRAWER, PETER A (PHD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:A
Last Name:BRAWER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 W ARGONNE DR STE F
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63122-4237
Mailing Address - Country:US
Mailing Address - Phone:314-413-1794
Mailing Address - Fax:
Practice Address - Street 1:220 W ARGONNE DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63122-4237
Practice Address - Country:US
Practice Address - Phone:314-413-1764
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009026814103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI007057176Medicare ID - Type Unspecified