Provider Demographics
NPI:1053379776
Name:ABBEY, ELLIOT (MD)
Entity type:Individual
Prefix:DR
First Name:ELLIOT
Middle Name:
Last Name:ABBEY
Suffix:
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 1:232 S WOODS MILL RD
Mailing Address - Street 2:330 EAST
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-3417
Mailing Address - Country:US
Mailing Address - Phone:314-205-6737
Mailing Address - Fax:
Practice Address - Street 1:232 S WOODS MILL RD
Practice Address - Street 2:330 EAST
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-3417
Practice Address - Country:US
Practice Address - Phone:314-205-6737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR7043207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO35616OtherCMR- GROUP HEALTH PLAN
MOE00431656769OtherAETNA
MO0745843OtherCIGNA
MO19511OtherBLUE SHIELD
MO206929606Medicaid
MO241962OtherGROUP HEALTH PLAN
MS1438632OtherUNITED HEALTHCARE
MO237556OtherHEALTHLINK
MO206929606Medicaid
MO161314704Medicare PIN