Provider Demographics
NPI:1588680771
Name:STEVEN F. WILLEY, MD, PC
Entity Type:Organization
Organization Name:STEVEN F. WILLEY, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:F
Authorized Official - Last Name:WILLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-469-0033
Mailing Address - Street 1:PO BOX 771470
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63177-2470
Mailing Address - Country:US
Mailing Address - Phone:314-432-2580
Mailing Address - Fax:314-432-0223
Practice Address - Street 1:224 S. WOODSMILL RD
Practice Address - Street 2:SUITE 560
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63017
Practice Address - Country:US
Practice Address - Phone:314-469-0033
Practice Address - Fax:314-469-0088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMD107032207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty