Individual
THOMAS F MUSICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12700 SOUTHFORK ROAD, SUITE 250, ST. LOUIS, MO 63128-3286
(314) 842-0112
(314) 842-5505
Mailing address
12700 SOUTHFORK ROAD, SUITE 250, ST. LOUIS, MO 63128-3286
(314) 842-0112
(314) 842-5505
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R7857
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
184175
BCBS OF MISSOURI
MO
01
—
4944
BLUE CHOICE BCBS MO
MO
Enumeration date
10/28/2005
Last updated
06/18/2009
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