Individual
JOHN T ELLENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1040 N MASON RD STE 102, SAINT LOUIS, MO 63141-6361
(314) 758-6053
Mailing address
1040 N MASON RD STE 102, SAINT LOUIS, MO 63141-6361
(314) 758-6053
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
36600
MO
Other
Enumeration date
08/16/2006
Last updated
09/25/2025
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