Individual
ERIK P THYSSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
SPECIALISTS IN GASTROENTEROLOGY, 11525 OLDE CABIN ROAD, CREVE COEUR, MO 63141
(314) 997-0554
(314) 997-5086
Mailing address
11525 OLDE CABIN RD, CREVE COEUR, MO 63141-7146
(314) 997-0554
(314) 997-5086
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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