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Individual

KEITH R THOMAE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3533 DUNN RD, SUITE 210, FLORISSANT, MO 63033-6761
(314) 838-6600
(314) 838-6611
Mailing address
3331 W DEYOUNG ST, STE 305, MARION, IL 62959-5898
(314) 838-6600
(314) 838-6611

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2010011996
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036081399
IL
Enumeration date
05/24/2006
Last updated
02/22/2017
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