Provider Demographics
NPI:1255386694
Name:FENDLER, CRAIG STEVEN (CRAIG FENDLER)
Entity type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:STEVEN
Last Name:FENDLER
Suffix:
Gender:M
Credentials:CRAIG FENDLER
Other - Prefix:
Other - First Name:CRAIG
Other - Middle Name:STEVEN
Other - Last Name:FENDLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRAIG FENDLER CT
Mailing Address - Street 1:915 N GRAND BLVD
Mailing Address - Street 2:ANATOMIC PATHOLOGY JC-113
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63106-1621
Mailing Address - Country:US
Mailing Address - Phone:314-652-4100
Mailing Address - Fax:314-289-7073
Practice Address - Street 1:915 N GRAND BLVD
Practice Address - Street 2:ANATOMIC PATHOLOGY JC-113
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63106-1621
Practice Address - Country:US
Practice Address - Phone:314-652-4100
Practice Address - Fax:314-289-7073
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOCT008339246QC2700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QC2700XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyCytotechnology