Basic Information
| Provider Information | |||||||||
| NPI: | 1598997439 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHNEIDER | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12855 N 40 DR STE 375 | ||||||||
| Address2: | |||||||||
| City: | SAINT LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631418657 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3145676071 | ||||||||
| FaxNumber: | 3145673321 | ||||||||
| Practice Location | |||||||||
| Address1: | 111 SAINT LUKES CENTER DR STE 40 | ||||||||
| Address2: | |||||||||
| City: | CHESTERFIELD | ||||||||
| State: | MO | ||||||||
| PostalCode: | 630173509 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3147419010 | ||||||||
| FaxNumber: | 3147415102 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/11/2009 | ||||||||
| LastUpdateDate: | 12/01/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/01/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | 20140007085 | MO | Y | Allopathic & Osteopathic Physicians | Urology | 208800000X | 0365157442 | IL | N | Allopathic & Osteopathic Physicians | Urology |
ID Information
| ID | Type | State | Issuer | Description | P01369724 | 01 | MO | RAILROAD MEDICARE | OTHER |