Individual
MATTHEW H NISSING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
915 N GRAND BLVD, SAINT LOUIS, MO 63106-1621
(314) 289-6434
Mailing address
201 BJC SAINT PETERS DR, SUITE 100, SAINT PETERS, MO 63376-3091
(636) 916-8200
(636) 926-3303
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
2002007106
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200603702
—
MO
Enumeration date
04/10/2006
Last updated
04/03/2024
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