Provider Demographics
NPI:1245283548
Name:PELOZA, JOHN HENRY (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:HENRY
Last Name:PELOZA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14825 N. OUTER 40 RD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-5058
Mailing Address - Country:US
Mailing Address - Phone:314-530-6350
Mailing Address - Fax:636-812-6240
Practice Address - Street 1:14825 N. OUTER 40 RD
Practice Address - Street 2:SUITE 310
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-5058
Practice Address - Country:US
Practice Address - Phone:314-530-6350
Practice Address - Fax:636-812-6240
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG7094207XS0117X
MO2022016370207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE15316Medicare UPIN
TX0098AFMedicare PIN
TX8113N0Medicare PIN
TX00509RMedicare PIN