Tollefsen, Douglas M

Tollefsen, Douglas M is an individual health care provider with primary practice located at 4921 Parkview Pl Fl 7 7Th Fl, Saint Louis MO 63110-1032. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology, which is considered as his primary health care specialty. Tollefsen, Douglas M can be contacted via phone (314) 362-8808.

Contact Information

Primary practice address
4921 Parkview Pl Fl 7 7Th Fl Saint Louis MO 63110-1032
Fax: (314) 362-8826
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology 207RH0000X R9558 Missouri

Profile Details

NPI number 1679599815
LBN Legal business name Tollefsen, Douglas M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2006
Last updated Jan 29th, 2018 - about 6 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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Identifiers

StateTypeNumberIssuer
All States NPI 1679599815 NPPES
Missouri MEDICAID 201385101
Missouri MEDICAID ENROLLED

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