Provider Demographics
NPI:1447276670
Name:STEPHENS, ANDREA L (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:L
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:226 S WOODS MILL RD
Mailing Address - Street 2:STE 55W
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-3662
Mailing Address - Country:US
Mailing Address - Phone:314-542-4953
Mailing Address - Fax:314-590-5942
Practice Address - Street 1:226 S WOODS MILL RD
Practice Address - Street 2:STE 55W
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-3662
Practice Address - Country:US
Practice Address - Phone:314-542-4953
Practice Address - Fax:314-590-5942
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2021-02-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MOR3P80207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO203102710Medicaid
IL$$$$$$$$$Medicaid
160041989Medicare PIN
MO203102710Medicaid
E95767Medicare UPIN
IL$$$$$$$$$Medicaid