MEDICARE: DR. DAVID JEFFREY EISENSTEIN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	036136527	IL
2	207ZP0101X	Anatomic Pathology Physician	036136527	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598757031
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID JEFFREY EISENSTEIN MD

Provider Business Mailing Address
First Line	:	660 S EUCLID AVE
Second Line	:	CB 8118
City	:	SAINT LOUIS
State	:	MO
Zip	:	63110-1010
Country	:	US
Telephone Number	:	314-362-5641
Fax Number	:	314-362-0369

Provider Business Practice Location Address
First Line	:	4500 MEMORIAL DR
Second Line	:	DEPT PATHOLOGY
City	:	BELLEVILLE
State	:	IL
Zip	:	62226-5360
Country	:	US
Telephone Number	:	618-233-7750
Fax Number	:	314-747-1710

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2005
Last Update Date	:	03/18/2025

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