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Contact Information

MAXWELL T FOHTUNG
4949 W PINE BLVD
SAINT LOUIS, MO63108
 Phone: 314-389-1496
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

208D00000X 99 Physician/Undefined Physician type[6]
 

Surgery

208600000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for MAXWELL T FOHTUNG · (Male)

NPI # 1982088571
Status Active
Credentials
Entity Individual
Enumeration date 07/14/2015
Last updated 03/31/2026 - About 2 months ago
Sole proprietor 1 No
Identifiers
  • CO License # DR.0069226
  • MO License # 2018011353
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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