Dr. Thomas J Blanke, MD
Surgery, Surgical Critical Care in Saint Louis, MO. Individual provider (NPI-1).
NPI number1659342913
StatusActive
Last updated in NPPESJan 17, 2014
Details
- NPI
- 1659342913
- Entity type
- Individual (NPI-1)
- Name
- Dr. Thomas J Blanke
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 26, 2006
- Last updated
- Jan 17, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2086S0102X | Surgery, Surgical Critical Care | 33592 | MO | Yes |
| 208600000X | Surgery | 33592 | MO |
Practice location
4901 Forest Park AveSte 420
Saint Louis, MO 63108-1402
Phone 314-362-9100 · Fax 314-362-9107
Mailing address
660 S Euclid AveC B 8109
Saint Louis, MO 63110-1010
Phone 314-362-9100 · Fax 314-362-9107
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