Provider Demographics
NPI:1518930502
Name:ARMBRUSTER, LISA LEE (MD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:LEE
Last Name:ARMBRUSTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 551
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63188-0551
Mailing Address - Country:US
Mailing Address - Phone:314-898-1700
Mailing Address - Fax:314-814-8542
Practice Address - Street 1:5701 CHIPPEWA ST
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63109-1544
Practice Address - Country:US
Practice Address - Phone:314-932-5690
Practice Address - Fax:314-932-5692
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2003007989207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO209146208Medicaid
G70216Medicare UPIN
G70216Medicare UPIN