Basic Information
Provider Information
NPI: 1578574844
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BARRETTE
FirstName: ERNIE-PAUL
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 660 S EUCLID AVE
Address2: CB 8121
City: SAINT LOUIS
State: MO
PostalCode: 631101010
CountryCode: US
TelephoneNumber: 3143625060
FaxNumber: 3143626959
Practice Location
Address1: 4950 CHILDRENS PL
Address2: DIV IM INFECTIOUS DISEASE
City: SAINT LOUIS
State: MO
PostalCode: 631101000
CountryCode: US
TelephoneNumber: 3143629098
FaxNumber: 3143629851
Other Information
ProviderEnumerationDate: 08/11/2006
LastUpdateDate: 11/15/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X2007030485MON Allopathic & Osteopathic PhysiciansInternal Medicine 
207RI0200X2007030485MOY Allopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease

ID Information
IDTypeStateIssuerDescription
20834800305MO MEDICAID


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