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NPI Code Detail

MEDICARE: MR. THOMAS R PIONTEK CRNA

MEDICARE: MR. THOMAS R PIONTEK CRNA
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
1163W00000XRegistered NurseRN070195MO
2367500000XCertified Registered Nurse Anesthetist070195MO

Other Identifiers

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

General Provider Information

NPI Number : 1407837735
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. THOMAS R PIONTEK CRNA
Provider Business Mailing Address
First Line : PO BOX 502852
Second Line :
City : ST. LOUIS
State : MO
Zip : 63150-2852
Country : US
Telephone Number : 314-364-4200
Fax Number :
Provider Business Practice Location Address
First Line : 901 E 5TH ST
Second Line :
City : WASHINGTON
State : MO
Zip : 63090-3127
Country : US
Telephone Number : 636-239-8301
Fax Number : 636-390-7387
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2005
Last Update Date : 11/05/2021

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