Provider Demographics
NPI:1609925809
Name:EHLERT, TAMARA KAY (MD)
Entity Type:Individual
Prefix:DR
First Name:TAMARA
Middle Name:KAY
Last Name:EHLERT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:522 N NEW BALLAS RD
Mailing Address - Street 2:
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141-6857
Mailing Address - Country:US
Mailing Address - Phone:314-991-9030
Mailing Address - Fax:314-991-9033
Practice Address - Street 1:522 N NEW BALLAS RD
Practice Address - Street 2:SUITE 300
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-6857
Practice Address - Country:US
Practice Address - Phone:314-991-9030
Practice Address - Fax:314-991-9033
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMO R4H93207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery