Provider Demographics
NPI:1295129187
Name:CAMPBELL, COURTNEY MICHELLE (MD)
Entity type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:MICHELLE
Last Name:CAMPBELL
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Gender:F
Credentials:MD
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Mailing Address - Street 1:660 S EUCLID AVE
Mailing Address - Street 2:CB 8086
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1010
Mailing Address - Country:US
Mailing Address - Phone:314-362-1291
Mailing Address - Fax:314-362-4278
Practice Address - Street 1:1 BARNES JEWISH HOSPITAL PLZ
Practice Address - Street 2:DIV IM CARDIOLOGY
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1003
Practice Address - Country:US
Practice Address - Phone:314-362-1291
Practice Address - Fax:314-362-4278
Is Sole Proprietor?:No
Enumeration Date:2015-03-27
Last Update Date:2021-11-15
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Provider Licenses
StateLicense IDTaxonomies
MO2021014851207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200096880Medicaid