Provider Demographics
NPI:1508864810
Name:SOLMAN, COREY G JR (MD)
Entity Type:Individual
Prefix:DR
First Name:COREY
Middle Name:G
Last Name:SOLMAN
Suffix:JR
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 1:10435 CLAYTON RD STE 120
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-2930
Mailing Address - Country:US
Mailing Address - Phone:314-442-4452
Mailing Address - Fax:866-216-3928
Practice Address - Street 1:10435 CLAYTON RD STE 120
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-2930
Practice Address - Country:US
Practice Address - Phone:314-442-4452
Practice Address - Fax:866-216-3928
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002007887207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO205832405Medicaid
127543OtherGROUP HEALTH PLAN
7767243OtherAETNA
009262OtherSSM EXCLUSIVE CHOICE
200043352OtherRR MEDICARE
MO157622OtherBLUE CROSS BLUE SHIELD
P11210884OtherMULTIPLAN
0900974OtherUNITED HEALTH CARE
MO477865OtherHEALTHLINK
MO000095431Medicare ID - Type Unspecified
7767243OtherAETNA
P11210884OtherMULTIPLAN
000012252Medicare ID - Type Unspecified
127543OtherGROUP HEALTH PLAN