Provider Demographics
NPI:1144214297
Name:PIEPER, STEPHEN J (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:J
Last Name:PIEPER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 N NEW BALLAS RD
Mailing Address - Street 2:STE 270 W
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-6835
Mailing Address - Country:US
Mailing Address - Phone:314-991-6969
Mailing Address - Fax:314-997-6969
Practice Address - Street 1:450 N NEW BALLAS RD
Practice Address - Street 2:STE 270 W
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-6835
Practice Address - Country:US
Practice Address - Phone:314-991-6969
Practice Address - Fax:314-997-6969
Is Sole Proprietor?:No
Enumeration Date:2005-09-06
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR5N46207RC0000X, 207RC0001X
MN34928207RC0000X
IL036-093138207RC0000X
MN138830207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO005013185OtherMEDICARE PROV ID AREA 99
MO000047049OtherMCARE CCL GROUP NUMBER
MO1144214297Medicaid
MO004012762OtherMEDICARE PROVIDER ID
MOCD6536OtherRR GROUP 01
MO990002433OtherRR MEDICARE NUMBER
MOCI7050OtherRR GROUP 99
MOCD6536OtherRR GROUP 01
MOF45288Medicare UPIN
MO1144214297Medicaid