Provider Demographics
NPI:1750387510
Name:WALENTYNOWICZ, JAMES E (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:E
Last Name:WALENTYNOWICZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:121 SAINT LUKES CENTER DR
Mailing Address - Street 2:STE 302
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-3509
Mailing Address - Country:US
Mailing Address - Phone:314-523-2595
Mailing Address - Fax:314-590-5947
Practice Address - Street 1:121 SAINT LUKES CENTER DR
Practice Address - Street 2:STE 302
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-3509
Practice Address - Country:US
Practice Address - Phone:314-523-2595
Practice Address - Fax:314-590-5947
Is Sole Proprietor?:No
Enumeration Date:2005-06-24
Last Update Date:2014-12-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MOR4J48207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOMA4487003Medicare PIN
MO000014066Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
MOE57381Medicare UPIN