Individual
ANDREW BERNARD THEILEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2711 LACLEDE STATION RD APT C, MAPLEWOOD, MO 63143-2825
(214) 681-9181
Mailing address
2711 LACLEDE STATION RD APT C, MAPLEWOOD, MO 63143-2825
(214) 681-9181
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2011017041
MO
Other
Enumeration date
06/28/2011
Last updated
06/28/2011
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