Individual
GARY MAASSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5034 GRIFFIN RD, SAINT LOUIS, MO 63128-3418
(314) 843-7333
(314) 843-9946
Mailing address
PO BOX 23340, SAINT LOUIS, MO 63156-3340
(314) 843-7333
(314) 843-9946
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
R7H60
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000010024
ESSENCE
MO
01
—
0400519
UHC
MO
01
—
127466
GHP
MO
01
—
127490
GHP
MO
01
—
25688
BCBS
MO
01
—
260293
HEALTHLINK
MO
01
—
26093
BCBS
MO
01
—
4540903
AETNA
MO
01
—
F92833
MERCY
MO
Enumeration date
11/07/2005
Last updated
09/24/2012
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