Individual
EVANGELOS G. TAMBASSIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1445 CHRISTY DR, JEFFERSON CITY, MO 65101-2853
(573) 636-3483
(573) 636-5315
Mailing address
1 SAINT ELIZABETH BLVD, O FALLON, IL 62269-1099
(217) 234-2120
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
036.117610
IL
207L00000X
Anesthesiology Physician
Primary
104008
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203941224
—
MO
Enumeration date
09/20/2005
Last updated
04/05/2022
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