Healthcare Provider Details

I. General information

NPI: 1669515094
Provider Name (Legal Business Name): STEPHEN YIM, MD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 02/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

226 S WOODS MILL RD STE 55W
CHESTERFIELD MO
63017-3417
US

IV. Provider business mailing address

232 S WOODS MILL RD
CHESTERFIELD MO
63017-3417
US

V. Phone/Fax

Practice location:
  • Phone: 314-469-4440
  • Fax: 314-576-2346
Mailing address:
  • Phone: 314-576-2490
  • Fax: 314-576-2473

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: RICK SONNE
Title or Position: DIRECTOR
Credential:
Phone: 314-576-2490