Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | R3N53 | MO |
N | 207VX0201X | Gynecologic Oncologist | R3N53 | MO |
NPI | 1043221047 |
---|---|
Provider Name | Dr. Stephen C Yim |
First Address | Chesterfield, MO 63017-3662 |
Second Address | Chesterfield, MO 63017-3662 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2006 |
Last Update Date | 12/03/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
160046009 | RR MEDICARE (01) | MO |
E16745 | (02) | |
P00657134 | RR MEDICARE (01) | MO |