Thomas J. Stauder
Internist Emergency Physician Allergist
1906 Powderhorn Pass Ct
Wildwood
, Missouri 63011-1717
Thomas J. Stauder
Internist Emergency Physician Allergist
1906 Powderhorn Pass Ct
Wildwood
, Missouri 63011-1717
(636) 458-4188
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About
Features
Specialties
- Allergist
- Emergency Physician
- Internist
Languages spoken
- English
Location
First Address
- Thomas J. Stauder
- 1906 Powderhorn Pass Ct
- Wildwood, MO
- Zip : 63011-1717
- Phone : (636) 458-4188
Second Address
- Thomas J. Stauder
- 1906 Powderhorn Pass Ct
- Wildwood, MO
- Zip : 63011-1717
- Phone : (636) 458-4188
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207KA0200X | Allergist | 105229 | MO |
| N | 207P00000X | Emergency Physician | 105229 | MO |
| N | 207R00000X | Internist | 105229 | MO |
| N | 111NI0900X | Internist | 105229 | MO |
National Provider Identifier
| NPI | 1679568570 |
|---|---|
| Provider Name | Thomas J. Stauder |
| First Address | Wildwood, MO 63011-1717 |
| Second Address | Wildwood, MO 63011-1717 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 16/09/2005 |
| Last Update Date | 23/11/2009 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1679568570 | (05) | MO |
| 208237339 | (05) | MO |
| 383495136 | BLUE CROSS BLUE SHIELD (01) | MO |
| F90838 | (02) | MO |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.