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Individual

DR. THOMAS J BLANKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4901 FOREST PARK AVE, STE 420, SAINT LOUIS, MO 63108-1402
(314) 362-9100
(314) 362-9107
Mailing address
660 S EUCLID AVE, C B 8109, SAINT LOUIS, MO 63110-1010
(314) 362-9100
(314) 362-9107

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
33592
MO
2086S0102X
Surgical Critical Care Physician
Primary
33592
MO

Other

Enumeration date
01/26/2006
Last updated
01/17/2014
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