Provider Demographics
NPI:1225146582
Name:SACHAR, JEROME DAVID (MD)
Entity Type:Individual
Prefix:
First Name:JEROME
Middle Name:DAVID
Last Name:SACHAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3023 N BALLAS
Mailing Address - Street 2:STE 440D
Mailing Address - City:ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131
Mailing Address - Country:US
Mailing Address - Phone:314-432-8181
Mailing Address - Fax:314-432-0090
Practice Address - Street 1:3023 N BALLAS
Practice Address - Street 2:STE 440D
Practice Address - City:ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131
Practice Address - Country:US
Practice Address - Phone:314-432-8181
Practice Address - Fax:314-432-0090
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR7C95207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO201920725Medicaid
A09559Medicare UPIN
MO001013327Medicare PIN