Provider Demographics
NPI:1356365423
Name:EMANUEL, JAMES P (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:P
Last Name:EMANUEL
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 1:845 N NEW BALLAS CT
Mailing Address - Street 2:STE 130
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141-9510
Mailing Address - Country:US
Mailing Address - Phone:314-997-1777
Mailing Address - Fax:317-997-6277
Practice Address - Street 1:845 N NEW BALLAS CT
Practice Address - Street 2:STE 130
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-9510
Practice Address - Country:US
Practice Address - Phone:314-997-1777
Practice Address - Fax:317-997-6277
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR1E25207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOE27161Medicare UPIN
MO002013398Medicare ID - Type UnspecifiedMEDICARE ID