Healthcare Provider Details

I. General information

NPI: 1740576909
Provider Name (Legal Business Name): JOSE BERNARDO SAENZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2011
Last Update Date: 04/17/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5201 MID AMERICA PLZ DIV IM GASTROENTEROLOGY, STE 2300
SAINT LOUIS MO
63129-0002
US

IV. Provider business mailing address

PO BOX 7412011
CHICAGO IL
60674-2011
US

V. Phone/Fax

Practice location:
  • Phone: 314-747-2066
  • Fax: 314-362-2357
Mailing address:
  • Phone: 314-747-2066
  • Fax: 314-362-2357

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number2013027478
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: