Provider Demographics
NPI:1952354706
Name:BENZ, STEPHEN M (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:M
Last Name:BENZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:12700 SOUTHFORK RD
Mailing Address - Street 2:STE 270
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-3201
Mailing Address - Country:US
Mailing Address - Phone:314-543-5284
Mailing Address - Fax:314-543-5276
Practice Address - Street 1:12700 SOUTHFORK RD
Practice Address - Street 2:STE 270
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-3201
Practice Address - Country:US
Practice Address - Phone:314-543-5284
Practice Address - Fax:314-543-5276
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2017-03-14
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Provider Licenses
StateLicense IDTaxonomies
MOR6P63207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO23374OtherBLUE CROSS BLUE SHIELD
MO338786OtherGROUP HEALTH PLAN
MO141956OtherHEALTHLINK
MO002011602OtherMEDICARE
MO200008584OtherMEDICARE RAILROAD
MO966851OtherAETNA
MO0900099OtherUNITED HEALTHCARE
MO200008584OtherMEDICARE RAILROAD
MOC70474Medicare UPIN