Basic Information
Provider Information
NPI: 1902292964
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TORCHIA
FirstName: MICHAEL
MiddleName: THOMAS
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 660 S EUCLID AVE
Address2: CB 8233
City: SAINT LOUIS
State: MO
PostalCode: 631101010
CountryCode: US
TelephoneNumber: 3145143500
FaxNumber: 3145143555
Practice Location
Address1: 4921 PARKVIEW PL
Address2: STE 6A/6B/12A
City: SAINT LOUIS
State: MO
PostalCode: 631101032
CountryCode: US
TelephoneNumber: 3147472551
FaxNumber: 3147472598
Other Information
ProviderEnumerationDate: 04/07/2015
LastUpdateDate: 11/15/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000X2021023186MOY Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 

No ID Information.


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