Organization
METRO EAST SURGICAL SPECIALTY SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH R THOMAE M.D. (PRESIDENT)
(618) 654-8100
Entity
Organization
Contact information
Practice address
1212 BROADWAY, SUITE B, HIGHLAND, IL 62249-1960
(618) 654-8100
Mailing address
1212 BROADWAY, SUITE B, HIGHLAND, IL 62249-1960
(618) 654-8100
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
042008099
IL
Other
Enumeration date
06/01/2006
Last updated
04/24/2009
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