Individual
DR. GUS THEODOS
Active
Sole proprietor
Yes
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
670 MASON RIDGE CENTER DR STE 300, SAINT LOUIS, MO 63141-8573
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
2016007344
MO
Other
Enumeration date
10/13/2006
Last updated
03/22/2021
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