Molleston, Jerome Michael

Molleston, Jerome Michael is an individual health care provider with primary practice located at 1 Childrens Pl Div Ped Gastro, Hepatology And Nutrition, Saint Louis MO 63110-1002. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Gastroenterology. Allopathic & Osteopathic Physicians / Pediatric Gastroenterology is his primary health care specialty. Molleston, Jerome Michael can be contacted via phone (314) 454-6173.

Contact Information

Primary practice address
1 Childrens Pl Div Ped Gastro, Hepatology And Nutrition Saint Louis MO 63110-1002
Phone: (314) 454-6173
Fax: (844) 231-8912
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 2019029285 Missouri
Allopathic & Osteopathic Physicians / Pediatric Gastroenterology 2080P0206X 2019029285 Missouri

Profile Details

NPI number 1356835342
LBN Legal business name Molleston, Jerome Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 21st, 2018
Last updated Jul 2nd, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356835342 NPPES
Missouri MEDICAID 200061524

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