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Individual

ERIK P THYSSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MDR3P63
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
003012657
MEDICARE LEGACY
MO
01
100008440
RAILROAD MEDICARE
01
1059638
UHC
01
107244
BLUE CROSS/BLUE SHIELD
05
203703103
MO
01
211593
HEALTHLINK
01
4288200
AETNA
01
43076
GHP
Enumeration date
08/17/2006
Last updated
03/08/2021
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