Provider Demographics
NPI:1407295512
Name:PEARSON, CHELSEA ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:CHELSEA
Middle Name:ELIZABETH
Last Name:PEARSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 60352
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63160-0352
Mailing Address - Country:US
Mailing Address - Phone:314-747-3969
Mailing Address - Fax:877-869-8163
Practice Address - Street 1:4921 PARKVIEW PL
Practice Address - Street 2:DIV IM GENERAL MED, STE 12B
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1032
Practice Address - Country:US
Practice Address - Phone:314-747-3969
Practice Address - Fax:877-869-8163
Is Sole Proprietor?:No
Enumeration Date:2013-06-21
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2015007389207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200037313Medicaid