Individual
ANDREA M HOLTHAUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3009 N BALLAS RD STE 383C, SAINT LOUIS, MO 63131-2324
(314) 996-4545
Mailing address
3009 N BALLAS RD STE 383C, SAINT LOUIS, MO 63131-2324
(314) 996-4545
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2004011870
MO
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
2004011870
MO
208M00000X
Hospitalist Physician
2004011870
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1528031473
—
IL
05
—
209226109
—
MO
Enumeration date
02/10/2006
Last updated
06/22/2021
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