Individual
DR. MATTHEW JOHN LOMMEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 BARNES JEWISH HOSPITAL PLZ, SAINT LOUIS, MO 63110-1003
(314) 362-7200
Mailing address
510 S KINGSHIGHWAY BLVD, DEPARTMENT OF RADIOLOGY, SAINT LOUIS, MO 63110-1076
(314) 362-7200
(314) 747-4189
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
4351047972
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200112145
MISSOURI MEDICAL LICENSE
MO
Enumeration date
05/28/2020
Last updated
08/10/2022
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