Provider Demographics
NPI:1962450288
Name:FROHBERG, NORA R (MD)
Entity Type:Individual
Prefix:
First Name:NORA
Middle Name:R
Last Name:FROHBERG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 HOSPITAL DR
Mailing Address - Street 2:HSTM VETERAN'S HOSPITAL, BEHAVIORAL HEALTH SERVICE
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-5275
Mailing Address - Country:US
Mailing Address - Phone:573-814-6000
Mailing Address - Fax:
Practice Address - Street 1:800 HOSPITAL DR
Practice Address - Street 2:HSTM VETERAN'S HOSPITAL, BEHAVIORAL HEALTH SERVICE
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-5275
Practice Address - Country:US
Practice Address - Phone:573-814-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1135712084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1553721OtherUNITED HEALTHCARE
MO208859801Medicaid
MO114587OtherBLUE SHIELD/BLUE CHOICE
MO335840OtherUNITED HEALTHCARE
MO208859801Medicaid
MO985010635Medicare PIN
MO260033328Medicare PIN
MO1553721OtherUNITED HEALTHCARE