Provider Demographics
NPI:1467834820
Name:SANZALONE, MATTHEW STRINGFELLOW (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:STRINGFELLOW
Last Name:SANZALONE
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:PO BOX 60352
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63160-0352
Mailing Address - Country:US
Mailing Address - Phone:314-362-8820
Mailing Address - Fax:314-362-1185
Practice Address - Street 1:4921 PARKVIEW PL
Practice Address - Street 2:DEPT ANESTHESIOLOGY, STE 14C
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1032
Practice Address - Country:US
Practice Address - Phone:314-362-8820
Practice Address - Fax:314-362-1185
Is Sole Proprietor?:No
Enumeration Date:2015-06-22
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019024502207LP2900X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200062651Medicaid