MEDICARE: PAUL ALTSHELER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	R7222	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00116104	OTHER	MO	MEDICARE RR#

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346225372
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL ALTSHELER MD

Provider Business Mailing Address
First Line	:	PO BOX 1209
Second Line	:
City	:	MARYLAND HEIGHTS
State	:	MO
Zip	:	63043-0209
Country	:	US
Telephone Number	:	314-739-3990
Fax Number	:	314-739-3924

Provider Business Practice Location Address
First Line	:	3009 N BALLAS RD # 203A
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63131-2322
Country	:	US
Telephone Number	:	314-739-3990
Fax Number	:	314-739-3924

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/13/2005
Last Update Date	:	04/19/2016

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Directions to “ PAUL ALTSHELER MD” Practice Location

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