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NPI Code Detail

MEDICARE: STEVEN E FERN DO

MEDICARE: STEVEN E FERN DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RG0100XGastroenterology PhysicianR8P03MO

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1100017272OTHERRAILROAD MEDICARE
6006012657OTHERMOMEDICARE LEGACY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2136256OTHERGHP
319561OTHERBLUE CROSS/BLUE SHIELD
44668959OTHERAETNA
51441643OTHERUHC
7270559OTHERHEALTHLINK
8MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1417982760
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEVEN E FERN DO
Provider Business Mailing Address
First Line : 965 MATTOX DR
Second Line :
City : SULLIVAN
State : MO
Zip : 63080-2365
Country : US
Telephone Number : 573-860-6000
Fax Number :
Provider Business Practice Location Address
First Line : 965 MATTOX DR
Second Line :
City : SULLIVAN
State : MO
Zip : 63080-2365
Country : US
Telephone Number : 573-860-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2006
Last Update Date : 09/22/2025

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Directions to “ STEVEN E FERN DO” Practice Location

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