Healthcare Provider Details

I. General information

NPI: 1992332274
Provider Name (Legal Business Name): SARA ANNE FICENEC MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2020
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6420 CLAYTON RD STE 2506
SAINT LOUIS MO
63117-1811
US

IV. Provider business mailing address

6420 CLAYTON RD STE 2506
SAINT LOUIS MO
63117-1811
US

V. Phone/Fax

Practice location:
  • Phone: 314-781-1505
  • Fax: 314-781-2840
Mailing address:
  • Phone: 314-781-1505
  • Fax: 314-781-2840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number2024009424
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: