Tieskoetter, Matthew Dale
Tieskoetter, Matthew Dale is an individual health care provider with primary practice located at 12349 De Paul Dr Ste 100 , Bridgeton MO 63044-2512. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as his primary health care specialty. Tieskoetter, Matthew Dale can be contacted via phone (314) 291-7900.Contact Information
Primary practice address
12349 De Paul Dr Ste 100
Bridgeton MO 63044-2512
Phone: (314) 291-7900
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 363LA2200X | 2020003584 | Missouri |
Profile Details
| NPI number | 1508482506 |
|---|---|
| LBN Legal business name | Tieskoetter, Matthew Dale |
| Credentials | Advanced Practice Registered Nurse (APRN) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 25th, 2020 |
| Last updated | Oct 17th, 2022 - about 2 years 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.
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