Healthcare Provider Details

I. General information

NPI: 1376517086
Provider Name (Legal Business Name): STEVEN R MUETH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 05/10/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3844 S LINDGBERGH BLVD STE 216
SAINT LOUIS MO
63127
US

IV. Provider business mailing address

PO BOX 505487
SAINT LOUIS MO
63150-5487
US

V. Phone/Fax

Practice location:
  • Phone: 314-525-0580
  • Fax: 314-525-0581
Mailing address:
  • Phone: 314-525-0580
  • Fax: 314-525-0581

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number106172
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: