Provider Demographics
NPI:1154936888
Name:SNITCAR, STEPAN
Entity type:Individual
Prefix:DR
First Name:STEPAN
Middle Name:
Last Name:SNITCAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10841 CHASE PARK LN APT E
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-5731
Mailing Address - Country:US
Mailing Address - Phone:667-234-3120
Mailing Address - Fax:667-234-3525
Practice Address - Street 1:625 S NEW BALLAS RD STE 7020
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8218
Practice Address - Country:US
Practice Address - Phone:314-251-6486
Practice Address - Fax:314-251-4155
Is Sole Proprietor?:No
Enumeration Date:2020-09-10
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023007660207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine