SearchMissouri208D00000X

Maxwell Fohtung

NPI 1982088571 · on the registry since 2015

Practice

Address
4949 W Pine Blvd
Saint Louis, MO 63108
Phone
(314) 389-1496
Clinicians at this address
2

Additional practice sites

  • 1 Barnes Jewish Hospital Plz, Saint Louis, MO

Registry record

Primary taxonomy
208D00000X
208D00000X
Also registered as
208D00000X
208600000X
Licence states on file
MO, CO
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2026-03-31

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Missouri