Dr. Jonathan W Heusel, MD
Pathology, Molecular Genetic Pathology in Saint Louis, MO. Individual provider (NPI-1).
NPI number1255329058
StatusActive
Last updated in NPPESNov 15, 2021
Details
- NPI
- 1255329058
- Entity type
- Individual (NPI-1)
- Name
- Dr. Jonathan W Heusel
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 6, 2005
- Last updated
- Nov 15, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207ZP0007X | Pathology, Molecular Genetic Pathology | 108616 | MO | Yes |
Practice location
4320 Forest Park AveSte 209
Saint Louis, MO 63108-2979
Phone 314-362-5641 · Fax 314-362-0369
Mailing address
660 S Euclid AveCb 8118
Saint Louis, MO 63110-1010
Phone 314-362-5641 · Fax 314-362-0369
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