Individual
DR. TIMOTHY WAYNE SCHLOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1203 SMIZER MILL RD, SUITE 102, FENTON, MO 63026-3483
(314) 251-1700
(314) 251-1701
Mailing address
1203 SMIZER MILL RD, SUITE 102, FENTON, MO 63026-3483
(314) 251-1700
(314) 251-1701
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
2004004905
MO
207RI0011X
Interventional Cardiology Physician
Primary
2004004905
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1881745909
—
MO
01
—
P01129269
RAILROAD MEDICARE
MO
Enumeration date
01/15/2007
Last updated
04/12/2017
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