Provider Demographics
NPI:1023099785
Name:MCLAUGHLIN, SEAN T (MD)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:T
Last Name:MCLAUGHLIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 23340
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63156-3340
Mailing Address - Country:US
Mailing Address - Phone:314-298-3893
Mailing Address - Fax:314-851-4408
Practice Address - Street 1:12277 DE PAUL DR
Practice Address - Street 2:SUITE 504
Practice Address - City:BRIDGETON
Practice Address - State:MO
Practice Address - Zip Code:63044-2516
Practice Address - Country:US
Practice Address - Phone:314-298-3893
Practice Address - Fax:314-851-4408
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO103473207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000000011298OtherESSENCE
MO0404100OtherUHC
MO0400966OtherUHC MEDICARE COMPLETE
MO208225029Medicaid
MO5344454OtherAETNA
MO332943OtherHEALTHLINK
MOD04067OtherEXCLUSIVE CHOICE
MO222031OtherGHP
MO10708OtherBCBS
MOG31690OtherMERCY
MO000000011298OtherESSENCE
MOG31690OtherMERCY
MO332943OtherHEALTHLINK