Thibodeaux, Suzanne Renee
Thibodeaux, Suzanne Renee is an individual health care provider with primary practice located at 425 S Euclid Ave Div Pa Lab And Genomic Med, Saint Louis MO 63110-1005. She recently has only one registered license in Allopathic & Osteopathic Physicians / Clinical Pathology, which is considered as her primary health care specialty. Thibodeaux, Suzanne Renee can be contacted via phone (314) 362-5641.Contact Information
Primary practice address
425 S Euclid Ave Div Pa Lab And Genomic Med
Saint Louis MO 63110-1005
Phone: (314) 362-5641
Fax: (314) 362-0369
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Clinical Pathology | 207ZC0006X | 2017030247 | Missouri |
Profile Details
| NPI number | 1073958658 |
|---|---|
| LBN Legal business name | Thibodeaux, Suzanne Renee |
| Credentials | MD PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 8th, 2013 |
| Last updated | Apr 25th, 2024 - about 8 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073958658 | NPPES |
| Missouri | MEDICAID | 200046010 |
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