Individual
DR. EDGAR THEODORE TUMANGUIL POLINTAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6420 CLAYTON ROAD SSM HEALTH ST. MARY'S HOSPITAL-ST LOU, DEPARTMENT OF INTERNAL MEDICINE, ST. LOUIS, MO 63117
(314) 768-8778
Mailing address
6420 CLAYTON ROAD SSM HEALTH ST. MARY'S HOSPITAL-ST LOU, DEPARTMENT OF INTERNAL MEDICINE, ST. LOUIS, MO 63117
(314) 768-8778
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
2023016707
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2023016707
MISSOURI PHYSICIAN LICENSENUMBER
MO
Enumeration date
06/29/2023
Last updated
12/27/2023
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