Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 2001012062 | MO |
N | 111NI0900X | Internist | 2001012062 | MO |
N | 207RC0200X | Critical Care Medicine | 01062755A | IN |
Y | 207RC0200X | Critical Care Medicine | 2001012062 | MO |
N | 207RP1001X | Pulmonary Disease | 2001012062 | MO |
NPI | 1083677520 |
---|---|
Provider Name | Stephen B Osmon |
First Address | Chesterfield, MO 63017-5670 |
Second Address | Bridgeton, MO 63044-2512 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2006 |
Last Update Date | 22/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200333607 | (05) | MO |
G57934 | (02) | MO |