Healthcare Provider Details

I. General information

NPI: 1205376852
Provider Name (Legal Business Name): SAVANNAH CHRISTINE KIPFER DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2017
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10012 KENNERLY RD STE 406
SAINT LOUIS MO
63128-2197
US

IV. Provider business mailing address

PO BOX 776084
CHICAGO IL
60677-6084
US

V. Phone/Fax

Practice location:
  • Phone: 314-525-1224
  • Fax:
Mailing address:
  • Phone: 314-362-5298
  • Fax: 888-824-2176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number2023025371
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number2023025371
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: