Healthcare Provider Details

I. General information

NPI: 1407998578
Provider Name (Legal Business Name): CONTEMPORARY OB-GYN PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 11/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 US HIGHWAY 61 SUITE 340
FESTUS MO
63028-4100
US

IV. Provider business mailing address

PO BOX 320 1400 HWY 61, STE. 340
CRYSTAL CITY MO
63019-0320
US

V. Phone/Fax

Practice location:
  • Phone: 636-937-1545
  • Fax: 636-937-8995
Mailing address:
  • Phone: 636-937-1545
  • Fax: 636-937-8995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberPOO291664
License Number StateMO

VIII. Authorized Official

Name: DR. WILLIAM F SNIDLE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 636-937-1545