Individual
DR. MARYJO HERNANDEZ-ZIPFEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4055 LINDELL BLVD, SAINT LOUIS, MO 63108-3201
(314) 535-7701
Mailing address
4055 LINDELL BLVD, SAINT LOUIS, MO 63108-3201
(314) 535-7701
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
2004009985
MO
2080N0001X
Neonatal-Perinatal Medicine Physician
2004009985
MO
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
2004009985
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
190299
MO-BLUE SHIELD
—
05
—
206177305
—
MO
Enumeration date
07/18/2006
Last updated
05/15/2019
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