Individual
THOMAS FAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6800 STATE ROUTE 162, MARYVILLE, IL 62062-8500
(618) 391-6140
(618) 288-2164
Mailing address
1831 CHESTNUT ST STE 650, SAINT LOUIS, MO 63103-2236
(314) 977-6828
(314) 977-6872
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
036160350
IL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
2020041595
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/14/2017
Last updated
05/27/2022
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