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General NPI Number Information
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NPI Number | 1902198781
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Entity Type | Individual
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Provider Name | MATTHEW E SCHOENHERR MD
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Gender | Male
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Dates
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Enumeration Date | 05/11/2011
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Last Update Date | 02/04/2021
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Provider Practice Location Address
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Address Line | 11125 DUNN RD STE. 406
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City | SAINT LOUIS
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State | MO
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Zip | 63136-6132
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Country | US
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Telephone | 314-653-5484
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Fax | 314-653-5483
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Provider Business Mailing Address
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Address Line | 670 MASON RIDGE CENTER DR STE. 300
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City | SAINT LOUIS
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State | MO
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Zip | 63141-8573
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Country | US
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Telephone | 314-653-5484
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Fax | 314-653-5483
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 60064-20
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2015018628
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License Number State | MO
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