DR. GUS THEODOS (NPI# 1053401422) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053401422 |
| Entity Type | Individual |
| Full Name | DR. GUS THEODOS |
| Credential | M.D. |
| Practice Address |
710 S Price Rd Saint Louis MO 63124-1867 |
| Practice Telephone | 2168494865 |
| Mailing Telephone | 2168494865 |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2018-04-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
2016007344 | MO | Allopathic & Osteopathic Physicians |
| Street Address |
710 S PRICE RD |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63124-1867 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174174775 | Nicholas Simpson | Nurse Practitioner | 8857 Ladue Road, St. Louis, MO 63124 | 2019-09-25 |
| 1144774647 | Carolyn Ashley Myles Versical | Psychologist | 26 Godwin Ln, Saint Louis, MO 63124 | 2016-08-12 |
| 1740669373 | Victor's Home Care Cds, LLC | Hospice Care, Community Based | 8420 Delmar Blvd, Ste 507, St. Louis, MO 63124 | 2015-05-28 |
| 1851784490 | Bryan Watanabe Dds Ladue Dental Group, PC | Dentist | 8859 Ladue Road, Ladue, MO 63124 | 2015-03-06 |
| 1689072324 | Ladue Internal Medicine, LLC | Internal Medicine | 8857 A Ladue Rd., Ladue, MO 63124 | 2014-12-11 |
| 1043557150 | Ronald Nathan Riner | Internal Medicine | 9847 Waterbury Drive, St. Louis, MO 63124 | 2013-01-09 |
| 1295099638 | David Stuart Sonderman | Pediatrics | 8888 Ladue Road, Ste 100, Saint Louis, MO 63124 | 2012-06-29 |
| 1255637799 | Kyu S Her | Pediatrics | 624 Haverford Road, St. Louis, MO 63124 | 2011-02-01 |
| 1194983833 | Roberte Kuhlman | Orthopaedic Surgery | 12 Upper Barnes, St Louis, MO 63124 | 2008-05-29 |
| 1467507673 | Mark William Aylward | Dentist | 9216 Clayton Road, Suite 118, St Louis, MO 63124 | 2007-01-25 |
| Find all providers in zip 63124 | ||||
| Taxonomy Code | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437658440 | Cardiac Cin of St Louis LLC | Internal Medicine | 11628 Old Ballas Rd # 346, Saint Louis, MO 63141-7030 | 2018-02-05 |
| 1013909613 | Paul H Gibson | Internal Medicine | 11188 Tesson Ferry Road, Suite 100, Saint Louis, MO 63123 | 2005-08-19 |
| 1629207477 | Elsayed Salem Abo-salem | Internal Medicine | 3635 Vista Ave, Saint Louis, MO 63110-2539 | 2009-07-14 |
| 1538302567 | Edward David Coverstone | Internal Medicine | 10012 Kennerly Rd, Suite 300, Saint Louis, MO 63128-2197 | 2009-04-06 |
| 1962509992 | County Cardiology, Inc. | Internal Medicine | 10004 Kennerly Rd, Suite 247, Saint Louis, MO 63128-2141 | 2006-09-20 |
| 1548274749 | Sundeep Das | Internal Medicine | 11155 Dunn Rd, Ste 304e, Saint Louis, MO 63136-6150 | 2006-07-27 |
| 1396769055 | Rafiq Ramadan | Internal Medicine | 11155 Dunn Rd, Ste 304e, Saint Louis, MO 63136-6150 | 2006-07-27 |
| 1346264017 | Harvey Serota | Internal Medicine | 11155 Dunn Rd, Ste 304e, Saint Louis, MO 63136-6150 | 2006-07-27 |
| 1437173119 | Gil M Vardi | Internal Medicine | 11155 Dunn Rd, Ste 304e, Saint Louis, MO 63136-6150 | 2006-07-27 |
| 1992728000 | Usman Qayyum | Internal Medicine | 11155 Dunn Rd, Suite 304e, Saint Louis, MO 63136-6150 | 2006-07-26 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63124 |
Please comment or provide details below to improve the information on DR. GUS THEODOS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.