Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 2006017632 | MO |
Y | 207X00000X | Orthopaedic Surgeon | 2006017632 | MO |
N | 207X00000X | Orthopaedic Surgeon | 65970 | GA |
NPI | 1982718268 |
---|---|
Provider Name | Andrew Thomas Gelven |
First Address | Saint Louis, MO 63195-5534 |
Second Address | Wentzville, MO 63385-3814 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2006 |
Last Update Date | 05/08/2021 |