Provider Demographics
NPI:1023099140
Name:KNAPP, WILLIAM STEPHEN (DO)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:STEPHEN
Last Name:KNAPP
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 23340
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63156-3340
Mailing Address - Country:US
Mailing Address - Phone:314-831-0181
Mailing Address - Fax:314-851-4471
Practice Address - Street 1:2137 CHARBONIER RD STE B
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63031-5500
Practice Address - Country:US
Practice Address - Phone:314-831-0181
Practice Address - Fax:314-851-4471
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR8885207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOD92020OtherEXCLUSIVE CHOICE
MO0100004OtherUHC
MO241162304Medicaid
MOD41519OtherMERCY
MO127448OtherGHP
MO4037831OtherAETNA
MO9108OtherBCBS
MO000000010021OtherESSENCE
MO100734OtherHEALTHLINK
080119238Medicare PIN
MO100734OtherHEALTHLINK
MO000000010021OtherESSENCE
MOD41519Medicare UPIN