Provider Demographics
NPI:1336357367
Name:LENNERZ, JOCHEN KLAUS MARIA (MD)
Entity Type:Individual
Prefix:
First Name:JOCHEN
Middle Name:KLAUS MARIA
Last Name:LENNERZ
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 1:4605 LINDELL BLVD
Mailing Address - Street 2:APT. 904
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108-3717
Mailing Address - Country:US
Mailing Address - Phone:314-361-5645
Mailing Address - Fax:
Practice Address - Street 1:660 S EUCLID AVE
Practice Address - Street 2:NORTH SUITE B
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1010
Practice Address - Country:US
Practice Address - Phone:314-747-1247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008020877207ZP0007X, 207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
No207ZP0007XAllopathic & Osteopathic PhysiciansPathologyMolecular Genetic Pathology