Individual
JEREMY R TIETJENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3023 N BALLAS RD STE 200D, SAINT LOUIS, MO 63131-2328
(314) 996-7272
Mailing address
3023 N BALLAS RD STE 200D, SAINT LOUIS, MO 63131-2328
(314) 996-7272
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2020020220
MO
207RI0011X
Interventional Cardiology Physician
Primary
2020020220
MO
Other
Enumeration date
03/26/2012
Last updated
08/30/2021
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