Provider Demographics
NPI:1316010358
Name:HANTMAN, STEPHEN LEWIS (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:LEWIS
Last Name:HANTMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:237 BLUFF VIEW CIRCLE
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63129
Mailing Address - Country:US
Mailing Address - Phone:314-525-1000
Mailing Address - Fax:314-525-4868
Practice Address - Street 1:10010 KENNERLY
Practice Address - Street 2:DEPT OF EMERGENCY SERVICE
Practice Address - City:ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-9923
Practice Address - Country:US
Practice Address - Phone:314-525-1000
Practice Address - Fax:314-525-4868
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO29105207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A11809Medicare UPIN