Individual
DR. LJ PUNCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5501 DELMAR BLVD STE A430, SAINT LOUIS, MO 63112-3079
(314) 624-0398
Mailing address
5501 DELMAR BLVD STE A430, SAINT LOUIS, MO 63112-3079
(314) 306-4378
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2015043978
MO
2086S0102X
Surgical Critical Care Physician
2015043978
MO
2086S0127X
Trauma Surgery Physician
2015049378
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200027894
—
MO
Enumeration date
02/22/2007
Last updated
08/26/2024
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