1306827829 NPI number — THOMAS SCHROYER M.D.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306827829 NPI number — THOMAS SCHROYER M.D.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

SCHROYER

Provider First Name:

THOMAS

Provider Middle Name:

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

M.D.

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1306827829

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

10/29/2020

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

PO BOX 23340

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

SAINT LOUIS

Provider Business Mailing Address State Name:

MO

Provider Business Mailing Address Postal Code:

63156-3340

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

314-851-1075

Provider Business Mailing Address Fax Number:

314-851-4446

Provider First Line Business Practice Location Address:

9930 WATSON RD

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

SAINT LOUIS

Provider Business Practice Location Address State Name:

MO

Provider Business Practice Location Address Postal Code:

63126-1827

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

314-984-8827

Provider Business Practice Location Address Fax Number:

314-984-0736

Provider Enumeration Date:

11/10/2005

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 2085R0202X , with the licence number:  2001028203 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 660882 . This is a "HEALTHLINK" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
• Identifier: I12602 . This is a "MERCY HEALTH" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
• Identifier: 144352 . This is a "BCBS" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
• Identifier: 1603322 . This is a "UHC" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
• Identifier: 221225 . This is a "GHP GOLD ADVANTAGE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
• Identifier: 7580572 . This is a "AETNA" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
• Identifier: 000000010866 . This is a "ESSENCE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
• Identifier: 890102 . This is a "MERCY" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
• Identifier: 208323709 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
• Identifier: 46280V3431 . This is a "HEALTHCARE USA" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
• Identifier: I12602 . This is a "MERCY HEALTH" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
• Identifier: 221223 . This is a "GHP" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".