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NPI Code Detail

MEDICARE: DR. THOMAS FREDERIC GANZ M.D.

MEDICARE: DR. THOMAS FREDERIC GANZ M.D.
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
1207V00000XObstetrics & Gynecology Physician2017010588MO

General Provider Information

NPI Number : 1447696802
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS FREDERIC GANZ M.D.
Provider Business Mailing Address
First Line : PO BOX 955534
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63195-5534
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 18800 SCHNUCKS DR STE B
Second Line :
City : WARRENTON
State : MO
Zip : 63383-1121
Country : US
Telephone Number : 636-456-3413
Fax Number : 636-379-1297
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/13/2013
Last Update Date : 06/06/2025

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