Active NPI
Douglas M Lublin, MD
- Clinical Pathology/Laboratory Medicine Physician
- Saint Louis, MO
National Provider Identifier
1457378960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Pathology/Laboratory Medicine Physician
- License
- R1H27
- Practice address
- 216 S Kingshighway Blvd
Saint Louis, MO 63110-1026 - Phone
- (314) 362-5641
- Fax
- (314) 362-0369
- NPI assigned
- Jul 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Blood Banking & Transfusion Medicine Physician | 207ZB0001X | R1H27 | MO | |
| Clinical Pathology/Laboratory Medicine Physician | 207ZP0105X | R1H27 | MO | Primary |
Addresses
Primary practice location
216 S Kingshighway Blvd
Saint Louis, MO 63110-1026
Mailing address
660 S Euclid Ave
C B 8118
Saint Louis, MO 63110-1010
Phone (314) 362-5641
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 705187201 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1313971200000",
"number": "1457378960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "660 S EUCLID AVE",
"address_2": "C B 8118",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631101010",
"telephone_number": "314-362-5641",
"fax_number": "314-362-0369"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "216 S KINGSHIGHWAY BLVD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631101026",
"telephone_number": "314-362-5641",
"fax_number": "314-362-0369"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUBLIN",
"first_name": "DOUGLAS",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-17",
"last_updated": "2011-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "207ZB0001X",
"taxonomy_group": "",
"desc": "Pathology, Blood Banking & Transfusion Medicine",
"state": "MO",
"license": "R1H27",
"primary": false
},
{
"code": "207ZP0105X",
"taxonomy_group": "",
"desc": "Pathology, Clinical Pathology/Laboratory Medicine",
"state": "MO",
"license": "R1H27",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "705187201",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.