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Individual

DR. JEFFREY FIERSTEIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2120 MADISON AVE, SUITE 200, GRANITE CITY, IL 62040-4744
(618) 451-1800
(618) 451-1526
Mailing address
1 E WALINCA WALK, SAINT LOUIS, MO 63105-2006

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
1226911
NY
207Y00000X
Otolaryngology Physician
R4761
MO
207Y00000X
Otolaryngology Physician
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2013746
MO
Enumeration date
03/17/2006
Last updated
01/23/2008
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