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Individual

DR. JERROLD J LANDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
222 S WOODS MILL RD, SUITE 750, CHESTERFIELD, MO 63017-3625
(314) 205-6600
(314) 434-5939
Mailing address
222 S WOODS MILL RD, SUITE 750, CHESTERFIELD, MO 63017-3625
(314) 205-6600
(314) 434-5939

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
31787
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200591204
MO
01
841682728
TAX ID
01
P00255776
RR MEDICARE
Enumeration date
08/20/2006
Last updated
08/06/2015
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