Provider Demographics
NPI:1861449753
Name:TEPPER, ARNOLD S (MD)
Entity Type:Individual
Prefix:
First Name:ARNOLD
Middle Name:S
Last Name:TEPPER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:224 S WOODS MILL RD
Mailing Address - Street 2:SUITE 435 SOUTH
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-3451
Mailing Address - Country:US
Mailing Address - Phone:314-392-4762
Mailing Address - Fax:314-590-5937
Practice Address - Street 1:224 S WOODS MILL RD
Practice Address - Street 2:SUITE 435 SOUTH
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-3451
Practice Address - Country:US
Practice Address - Phone:314-392-4762
Practice Address - Fax:314-590-5937
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO32851207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO201344801Medicaid
AT6959970OtherDEA
MO201344801Medicaid
MOA11062Medicare UPIN