Provider Demographics
NPI:1871574582
Name:NESTER, STEPHEN (MD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:NESTER
Suffix:
Gender:M
Credentials:MD
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:314-647-9444
Mailing Address - Fax:314-647-7317
Practice Address - Street 1:1031 BELLEVUE AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63117-1818
Practice Address - Country:US
Practice Address - Phone:314-647-9444
Practice Address - Fax:314-647-7317
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR3G70207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO101561OtherHEALTHLINK
MO000000010047OtherESSENCE
MO202841029Medicaid
MO2177998OtherAETNA US
MOA28411OtherMERCY
MO0100039OtherUHC
MO111791OtherBCBS
MO40340OtherGHP
MO4071506OtherAETNA
MO080163633Medicare PIN
MO0100039OtherUHC
MO202841029Medicaid