Individual
DR. TIMOTHY J MCCANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1717 BIDDLE ST, SAINT LOUIS, MO 63106-3454
(314) 898-1700
(314) 814-8542
Mailing address
PO BOX 551, SAINT LOUIS, MO 63188-0551
(314) 898-1700
(314) 814-8542
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
36802
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0035221
CARPENTERS SUPPLEMENT
—
01
—
0450305
UHC
—
01
—
104220083
MEDICARE ID-TYPE
MO
01
—
110232845
RR MEDICARE
—
01
—
112907
BCBS MO
—
01
—
1160032
CARE PARTNERS
—
01
—
210829
HEALTHLINK
—
01
—
2632
GHP ALL
—
01
—
431890869
GREAT WEST
—
01
—
7555001
AETNA
—
01
—
A11697
MERCY
—
Enumeration date
01/02/2006
Last updated
11/02/2016
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