Basic Information
| Provider Information | |||||||||
| NPI: | 1053379776 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ABBEY | ||||||||
| FirstName: | ELLIOT | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 232 S WOODS MILL RD | ||||||||
| Address2: | 330 EAST | ||||||||
| City: | CHESTERFIELD | ||||||||
| State: | MO | ||||||||
| PostalCode: | 630173417 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3142056737 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 232 S WOODS MILL RD | ||||||||
| Address2: | 330 EAST | ||||||||
| City: | CHESTERFIELD | ||||||||
| State: | MO | ||||||||
| PostalCode: | 630173417 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3142056737 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/02/2006 | ||||||||
| LastUpdateDate: | 04/29/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RX0202X | R7043 | MO | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology |
ID Information
| ID | Type | State | Issuer | Description | 35616 | 01 | MO | CMR- GROUP HEALTH PLAN | OTHER | E00431656769 | 01 | MO | AETNA | OTHER | 0745843 | 01 | MO | CIGNA | OTHER | 19511 | 01 | MO | BLUE SHIELD | OTHER | 206929606 | 05 | MO | MEDICAID | 241962 | 01 | MO | GROUP HEALTH PLAN | OTHER | 1438632 | 01 | MS | UNITED HEALTHCARE | OTHER | 237556 | 01 | MO | HEALTHLINK | OTHER |