Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 2012009736 | MO |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 2012009736 | MO |
NPI | 1104020957 |
---|---|
Provider Name | Scott William Zehnder |
First Address | Saint Louis, MO 63128-2786 |
Second Address | Saint Louis, MO 63141-7134 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2007 |
Last Update Date | 19/07/2019 |