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Contact Information

BRENDAN M FONG, MD
12855 N 40 DR STE 125
SAINT LOUIS, MO63141-8663
 Phone: 314-806-1770
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Neurological Surgery

207T00000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for BRENDAN M FONG · (Male)

NPI Number 1245670504
Status Active
Credentials MD
Entity Individual
Enumeration date 07/01/2013
Last updated 10/10/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 036158187
  • MO License # 2013020671
Hospital affiliation(s)
  • MISSOURI BAPTIST MEDICAL CENTER - (Acute Care)
    3015 N BALLAS RD
    TOWN AND COUNTRY, MO 63131
  • ST LUKES HOSPITAL - (Acute Care)
    232 S WOODS MILL RD
    CHESTERFIELD, MO 63017
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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