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General NPI Number Information
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NPI Number | 1093037038
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Entity Type | Organization
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Legal Business Name | STEPHEN R CRESPIN INC
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Dates
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Enumeration Date | 02/18/2010
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Last Update Date | 02/18/2010
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Provider Practice Location Address
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Address Line | 777 S NEW BALLAS RD SUITE 214 EAST
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City | SAINT LOUIS
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State | MO
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Zip | 63141-8705
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Country | US
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Telephone | 314-432-1128
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Fax | 314-432-1853
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Provider Business Mailing Address
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Address Line | 777 S NEW BALLAS RD SUITE 214 EAST
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City | SAINT LOUIS
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State | MO
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Zip | 63141-8705
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Country | US
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Telephone | 314-432-1128
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Fax | 314-432-1853
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STEPHEN RALPH CRESPIN
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Credential | M.D.
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Telephone | 314-432-1128
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | R3994
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License Number State | MO
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