Jerald A Maslanko, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

R4A03 Issued in MO

Practice address

1391 Smizer Mill Rd
Fenton, MO 63026-7306

Phone

(636) 343-3787

Fax

(636) 349-6081

NPI assigned

Dec 19, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386707396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1391 SMIZER MILL RD",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630267306",
            "telephone_number": "636-343-3787",
            "fax_number": "636-349-6081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1391 SMIZER MILL RD",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630267306",
            "telephone_number": "636-343-3787",
            "fax_number": "636-349-6081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASLANKO",
        "first_name": "JERALD",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "R4A03",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Fenton, MO
• Providers in Fenton, MO by specialty
• Internal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.