Individual
BRENT A NEUSCHWANDER-TETRI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1225 S GRAND BLVD FL 3, SAINT LOUIS, MO 63104-1016
(314) 257-3760
(314) 257-3761
Mailing address
1008 S SPRING AVE, SAINT LOUIS, MO 63110-2520
(314) 977-2140
(314) 977-1660
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
R3P51
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203018007
—
MO
Enumeration date
08/04/2006
Last updated
02/11/2021
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