Provider Demographics
NPI:1629697180
Name:BRUBAKER, MARGARET RACHEL BUTLER (MD)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:RACHEL BUTLER
Last Name:BRUBAKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:MARGARET
Other - Middle Name:RACHEL
Other - Last Name:BUTLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:660 S EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110
Mailing Address - Country:US
Mailing Address - Phone:314-273-4374
Mailing Address - Fax:
Practice Address - Street 1:1 BARNES JEWISH PLAZA
Practice Address - Street 2:
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110
Practice Address - Country:US
Practice Address - Phone:314-273-4374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-14
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023013930390200000X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program