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General NPI Number Information
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NPI Number | 1083366264
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Entity Type | Individual
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Provider Name | THOMAS EDWARD CONTURO MD, PHD
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Gender | Male
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Dates
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Enumeration Date | 01/19/2022
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Last Update Date | 10/10/2025
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Provider Practice Location Address
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Address Line | 4567 W PINE BLVD APT 312
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City | SAINT LOUIS
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State | MO
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Zip | 63108-2175
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Country | US
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Telephone | 314-288-6580
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Fax | 412-422-9876
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Provider Business Mailing Address
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Address Line | 4567 W PINE BLVD APT 312
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City | SAINT LOUIS
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State | MO
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Zip | 63108-2175
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Country | US
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Telephone | 314-288-6580
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Fax | 412-422-9876
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | 104463
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License Number State | MO
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