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Individual

DR. COLES E L'HOMMEDIEU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
12639 OLD TESSON RD, SUITE 115, SAINT LOUIS, MO 63128-2786
(314) 849-0311
(314) 849-4423
Mailing address
12639 OLD TESSON RD, SUITE 115, SAINT LOUIS, MO 63128-2786
(314) 849-0311
(314) 849-4423

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
2004012112
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0901680
UNITED HEALTHCARE
MO
01
191095
BLUE CROSS BLUE SHIELD
MO
05
2026180002
MO
01
220386
GROUP HEALTH PLAN
MO
01
668930
HEALTHLINK
MO
01
7248595
AETNA
MO
01
P00143831
RAILROAD MEDICARE
MO
Enumeration date
05/09/2006
Last updated
07/17/2019
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