Individual
DR. MARTIN D JENDRISAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4921 PARKVIEW PL, SUITE 8C, SAINT LOUIS, MO 63110-1032
(314) 362-2840
(314) 361-4197
Mailing address
7425 FORSYTH, C B 8221, SAINT LOUIS, MO 63105-2161
(314) 362-2840
(314) 361-4197
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
Primary
R2A43
MO
2086S0129X
Vascular Surgery Physician
R2A43
MO
Other
Enumeration date
07/14/2006
Last updated
01/09/2008
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