MEDICARE: DR. STEPHEN FRANCIS STATEN MD

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
1	207Q00000X	Family Medicine Physician	R2E40	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457351363
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN FRANCIS STATEN MD

Provider Business Mailing Address
First Line	:	4438 TELEGRAPH RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63129-3316
Country	:	US
Telephone Number	:	314-543-5996
Fax Number	:	314-543-5958

Provider Business Practice Location Address
First Line	:	4438 TELEGRAPH RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63129-3316
Country	:	US
Telephone Number	:	314-543-5996
Fax Number	:	314-543-5958

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	03/14/2017

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