Provider Demographics
NPI:1306827829
Name:SCHROYER, THOMAS (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:SCHROYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 23340
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63156-3340
Mailing Address - Country:US
Mailing Address - Phone:314-851-1075
Mailing Address - Fax:314-851-4446
Practice Address - Street 1:9930 WATSON RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63126-1827
Practice Address - Country:US
Practice Address - Phone:314-984-8827
Practice Address - Fax:314-984-0736
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20010282032085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO660882OtherHEALTHLINK
MOI12602OtherMERCY HEALTH
MO144352OtherBCBS
MO1603322OtherUHC
MO221225OtherGHP GOLD ADVANTAGE
MO7580572OtherAETNA
MO000000010866OtherESSENCE
MO890102OtherMERCY
MO208323709Medicaid
MO46280V3431OtherHEALTHCARE USA
ILI12602OtherMERCY HEALTH
MO221223OtherGHP
MO144352OtherBCBS
MO000000010866OtherESSENCE
MO660882OtherHEALTHLINK
MO1603322OtherUHC
MO46280V3431OtherHEALTHCARE USA