Basic Information
| Provider Information | |||||||||
| NPI: | 1306827829 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHROYER | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 23340 | ||||||||
| Address2: | |||||||||
| City: | SAINT LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631563340 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3148511075 | ||||||||
| FaxNumber: | 3148514446 | ||||||||
| Practice Location | |||||||||
| Address1: | 9930 WATSON RD | ||||||||
| Address2: | |||||||||
| City: | SAINT LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631261827 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3149848827 | ||||||||
| FaxNumber: | 3149840736 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/10/2005 | ||||||||
| LastUpdateDate: | 10/29/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/29/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | 2001028203 | MO | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | 660882 | 01 | MO | HEALTHLINK | OTHER | I12602 | 01 | MO | MERCY HEALTH | OTHER | 144352 | 01 | MO | BCBS | OTHER | 1603322 | 01 | MO | UHC | OTHER | 221225 | 01 | MO | GHP GOLD ADVANTAGE | OTHER | 7580572 | 01 | MO | AETNA | OTHER | 000000010866 | 01 | MO | ESSENCE | OTHER | 890102 | 01 | MO | MERCY | OTHER | 208323709 | 05 | MO | MEDICAID | 46280V3431 | 01 | MO | HEALTHCARE USA | OTHER | I12602 | 01 | IL | MERCY HEALTH | OTHER | 221223 | 01 | MO | GHP | OTHER |