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Individual

AMY ELIZABETH THOMAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1465 SOUTH GRAND 6644, ST LOUIS, MO 63104
(314) 577-5369
Mailing address
1465 SOUTH GRAND, G644, ST LOUIS, MO 63104
(314) 577-5369

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2004034267
MO
2085R0001X
Radiation Oncology Physician
2004034267
MO

Other

Enumeration date
10/05/2006
Last updated
01/09/2008
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